CPJE SECRETS Flashcards
Veetids
penicillin VK
counseling points for penicillin VK
take on an empty stomach
Timentin
ticarcillin/clavulanic
Zosyn
piperacillin/tazobactam
Principen
ampicillin
Unasyn
ampicillin/sulbactam
Amoxil
amoxiciilin
Augmentin
amoxicillin/sulbactam
dosing frequency for amoxicillin
Q8-12H PO WITHOUT food
counseling points about augmentin
- REFRIGERATE suspension
- ok for 14 days at room temperature
DOC for acute otitis media, H. pylori & endocarditis
augmentin or amoxicillin
which penicillins covers PSA
ticarcillin/clavulanic [Timentin]
piperacillin/tazobactam [Zosyn]
extended spectrum PCNs are used for SSTIs, endocarditis, bone & joint ifx
naficillin [Nafcil, Nallpen] IV
oxacillin [Bactocill] IV
dicloxacillin [Dynapen] PO
Nafcil
nafcillin
Nallpen
nafcillin
Bactobil
oxacillin
Dynapen
dicloxacillin
penicillins clinical pearls
- renal metabolism/renal toxicity
- pregnancy category B
- ↓effectiveness birth control
- penicillin G salts [K, procaine, benzathine] are given by deep IM injection
which peniciilin G salts are given by deep IM inj?
K, procaine, benzathine
1st gen cephalosporins
- cefadroxil [Duricef]
- cefazolin [Ancef, Kefzol]
- cephalexin [Keflex]
what are 1st gen cephalosporins used for
gram(+), SSTIs
Duricef
cefadroxil
cefadroxil dosing
- 1-2 g Q12-24H PO
- CrCl 30-50: 500mg Q12H
- CrCl 10-30: 500mg Q24H
- CrCl <10: 500mg Q36H
Ancef
cefazolin
Kefzol
cefazolin
cefazolin dosing
- 1-2g Q8H IV/IM
- CrCl 10-30: Q12H
- CrCl <10: Q24H
Keflex
cephalexin
cephalexin dosing
- 250-500mg PO Q6H
- CrCl 10-30: Q8-12H
- CrCl <10: Q12-24H
2nd gen cephalosporins
- cefoxitin [Mefoxin]
- cefprozil [Cefzil]
- cefaclor [Ceclor]
- cefuroxime [Ceftin, Zinacef]
what 2nd gen cephalosporins cover
gram (+)/(-), respiratory
Mefoxin
cefoxitin
Cefzil
cefprozil
Ceclor
cefaclor
Ceftin
cefuroxime
Zinacef
cefuroxime
cefoxitin dosing
- 1-2g Q4-6H IV/IM
- CrCl 30-50: Q8-12H
- CrCl 10-30: Q12-24H
- CrCl <10L Q24-48H
cefprozil dosing
- 250-500mg PO Q12-24H
- CrCl <30: 1/2 dose
cefaclor dosing
- 250-500mg PO Q8H
- CrCl <10: 1/2 dose
cefuroxime dosing
- 0.25-1.5g IV/IM/PO Q8-12H
- CrCl 10-30: Q12H
- CrCl <10: Q24H
3rd gen cephalosporins
- cefdinir [Omnicef]
- ceftazidime [Fortaz]
- ceftriaxone [Rocephin]
- cefotaxime [Claforan]
- cefixime [Suprax]
Omnicef
cefdinir
Fortaz
ceftazidime
Rocephin
ceftriaxone
Claforan
cefotaxime
Suprax
cefixime
cefdinir dosing
- 300-600mg PO Q12-24H
- CrCl 10-30: Q24H
- CrCl <10: QOD
ceftazidime dosing
- 1-2g IV/IM Q8H
- CrCl 30-50: Q12H
- CrCl 10-30: Q24H
- CrCl <10: 500mg Q24H
ceftriaxone dosing
- 1-2g IV/IM Q12-24H
- no renal adjustments
cefotaxime dosing
- 1-2g IV/IM Q6-8H
- CrCl <10: Q24H
cefixime dosing
- 200-400mg PO Q12-24H
- CrCl 30-50: decrease by 25%
- CrCl <30: decrease by 50%
4th gen cephalosporins
cefepime [Maxipime]
Maxipime
cefepime
cefepime dosing
- 0.5-2g IV/IM Q8H
- CrCl <50: Q24H
5th gen cephalosporin
ceftaroline [Teflaro]
Teflaro
ceftaroline
ceftaroline dosing
- 400-600mg IV Q12H
- CrCl 10-30: 300mg
- CrCl <10: 200mg
which cephalosporins cover PSA
ceftazidime & cefepime
cephalosporins clinical pearls
- renal metabolism/toxicity [except ctx]
- C.diff colitis
- preg cat B
- 1% cross sensitivity w/ PCNs → use 3rd gen
Zerbaxa
ceftolozane/tazobactam
Avycaz
ceftazidime/avibactam
which cephalosporins can be used for IAIs & UTIs
zerbaxa & avycaz
- given IV
Fetroja
cefiderocol
what dose Fetroja cover
- siderophore cephalosporin for complicated UTIs
- gram(-) coverage
what do carbapenems cover
- gram +/- & anaerobes
- PSA except ertapenem
Primaxin
imipenem/cilastatin
Merrem
meropenem
Invanz
ertapenem
Doribax
doripenem
imipenem/cilstatin dosing
1g Q6H IV
meropenem dosing
2g IV/IM Q8H
ertapenem dosing
1g IV/IM QD
doripenem dosing
500mg IV Q8H
carbapenem clinical pearls
- renal metabolism/toxicity
- risk of seizures
- preg cat B → cat C for imipenem
- allergic rxn rare in pts w/ rxn to pcn
Recarbio
imipenem/cilastatin/relebactam
what does Recarbio cover
- complicated UTIs or IAIs
- combo with renal dehydropeptidase inhibitor & beta-lactamase inhibitor
what do monobactams cover
gram (-)
PSA
monobactams
aztreonam [Azactam]
Azactam
aztreonam
aztreonam dosing
2g IV Q8H
monobactam clinical pearls
- renal dosing
- ok w/ PCN allergy → safe alternative for allergic pts w/ nosocomial ifx
macrolides
- azithromycin [Zithromax, Z-Pak]
- clarithromycin [Biaxin]
- erythromycin [EES, Ery-tab, Erythrocin]
- telithromycin [Ketek]
what do macrolides cover
- gram +/-
- URI, chlamydia, atypicals, CAP, anaeroves
- P450 blockers except azithromycin
Zithromax, Z-Pak
azithromycin
Biaxin
clarithromycin
EES, Ery-Tab, Erythrocin
erythromycin
Ketek
telithromycin
azithromycin dosing
- 500mg day 1 + 250mg days 2-5
- 500mg x3 days
- no renal adjustment
- tk w/ or w/o food → ER susp on EMPTY STOMACH
clarithromycin dosing
- 1g QD WITH FOOD
- CrCl <30: 1/2 dose
- causes metallic taste
erythromycin dosing
- 400mg PO QID w/ or w/o food
- REFRIGERATE SUSP
telithromycin dosing
- 800mg PO QD
macrolide clinical pearls
- azithro & clarithro susp: DO NOT REFRIGERATE
- QT prolongation [not telithro]
- preg cat B: azithro & erythro
- preg cat C: clarithro
- SE: GI, cholestatic hepatitis [rare], allergies are rare
telithromycin clinical pearls
- CI: allergy to macrolides
- BBW: DNU in myasthenia gravis [respiratory failure]
- MedGuide → preg cat C
- monitor visual adverse effects & loss of consciousness
lincosamide abx
clindamycin [Cleocin]
gram(+)
Cleocin
clindamycin
clindamycin dosing
- 450mg PO TID-QID w/ or w/o food
- 600-900mg IV Q6-8H
clindamycin clinical pearls
- BBW: C.diff colitis
- preg cat B
- do NOT refrigerate
fluoroquinolones abx
- ofloxacin [Floxin]
- ciprofloxacin [Cipro]
- delafloxacin [Baxdela]
- levofloxacin [Levaquin]
- moxifloxacin [Avelox, Vigamox]
- gemifloxacin [Factive]
fluoroquinolones coverage
- gram +/-
- atypicals
fluoroquinolones clinical pearls
- no need to take food
- do NOT refrigerate
- BBW: tendon rupture, peripheral neuropathy, CNS effects
- photosensitivity → avoid skin sun exposure
- hypoglycemia → check sugars
- crystalluria → hydrate
- seizures → avoid if seizure hx
- c.diff diarrhea
- QT prolongation
- preg cat C → cartilage damage
- interacts w/ multivalent cations → antacids, didanosine [Videx], iron, Zn, sucralfate [Carafate], resins, MV, dairy
- inhibit CYP450 → increase INR
- renal dose adjustments [except moxi]
- gatifloxacin for eye infections only
FQ risk of QT prolongation
moxi > levo > cipro
Floxin
ofloxacin
Cipro
ciprofloxacin
Baxdela
delafloxacin
Levaquin
levofloxacin
Avelox, Vigamox
moxifloxacinF
Factive
gemifloxacin
which are respiratory FQs
levo, moxi, gemi
ofloxacin dosing
400mg Q12H PO/otic
which FQ is the most potent CYP inhibitor
cipro
ciprofloxacin dosing
- 200-400mg IV/opth/otic Q8H
- 250-750mg PO BID or QD
delafloxacin dosing
- 300mg IV
- 450mg PO
- for SSTIs
levofloxacin dosing
- 500-750mg IV/PO/opth QD
CrCl <50L
- 750mg Q24H → Q48H
- 500mg Q24H → 500mg x1 then 250mg Q24H
- 250mg Q24H → no dose adjustment
moxifloxacin dosing
- 400mg Q24H IV/PO/opth
- no renal dosing
gemifloxacin
- 320mg Q24H IV/PO
tetracyclines coverage
- atypicals, rickettsial, VRE
- anthrax, syphilis, MRSA, lyme, rocky mountain spotted fever, skin & urinary ifx
tetracyclines abx
- doxycycline [Vibramycin/Doryx]
- minocycline [Minocin, Dynacin, Solodyn]
- tetracyclin [Sumycin]
- tigecycline [Tygacil]
- omadacycline [Nuzrya] → CAP & SSTIs
- eravacycline [Xerava] → complicated IAIs
tetracyclines clinical pearls
- doxy: tk w/ food to decrease GI SE
- all: tk w/ water to decrease GI, upright 30 min
- photosensitivity
- CI: children ≤8 [tooth discoloration]
- preg cat D → avoid!!
- interacts w/ multivalent cations
- inhibits CYP450 → increases INR
Vibramycin
doxycycline
Doryx
doxycycline
Minocin
minocycline
Dynacin
minocycline
Solodyn
minocycline
Sumycin
tetracycline
Tygacil
tetracycline
Nuzyra
omadacycline
Xerava
eravacycline
doxycycline dosing
100mg Q12H
minocycline dosing
100mg Q12H
tetracycline dosing
500mg Q6H
tigecycline
100mg x1, then 50mg Q12H IV
Synercid
quinupristin/dalfopristin
synercid coverage
gram(+), MRSA, VRE
Synercid dosing
7.5mg/kg IV Q8H
- no renal dose adjustment
Synercid clinical pearls
- D5W only
- SE: hyperbilirubinemia, phlebitis, myalgias
- volume must be ≥250mL to be given peripherally
- CYP3A4 inhibitor
Cubicin
daptomycin
daptomycin coverage
- gram (+), MRSA, VRE
- no pneumonia
daptomycin dosing
- 6mg/kg IV QD
- adjust in renal dysfunction
daptomycin clinical pearls
- NS only
- SE: rhabdomyolysis → monitor CPK, careful if pt n statin
Vibativ
telavancin
telavancin coverage
gram (+), MRSA
telavancin dosing
10 mg/kg IV QD
- adjust in renal dysfunction
telavancin clinical pearls
- BBW: preg cat C → need preg test prior
- 3A4/5 inhibitor & additive QT prolongation effects
Zyvox
linezolid
linezolid coverage
gram (+), MRSA, VRE
linezolid dosing
- 600mg Q12H PO/IV
- trough: <2 ug/mL
- peak: 12-26 ug/mL
linezolid clinical pearls
- do NOT refrigerate
- SE: myelosuppression
- MAOI → avoid tyramine foods, serotonergic drugs & adrenergic drugs [HTN crisis]
Flagyl
metronidazole
Tindamax
tinidazole
metronidazole & tinidazole coverage
- anaerobic
- bacterial vaginosis, amoebiasis, giardiasis, trichomoniasis [anaerobes, protozoa]
metronidazole & tinidazole dosing
- 500mg Q6H PO/IV
- TAKE WITH FOOD to prevent stomach upset
metronidazole & tinidazole clinical pearls
- SE: leukopenia, neutropenia, metallic taste, furry tongue, darkened urine, disulfiram-like rxn w/ alcohol
- most serious SE: CNS & convulsive seizures
- monitor: CBC, WBC w/diff
- preg cat B
- CYP2C9 inhibitor → increase INR & decrease birth control effect
- do NOT refrigerate IV form [crystals]
abx w/ narrow therapeutic window monitoring
- peak: 30 min after infusion [2-3 hour for vanco]
- trough: before next dose
abx w/ narrow therapeutic window
- AMGs
- vanco
- chloramphenicol
aminoglycosides
- gentamicin
- tobramycin
- amikacin
AMG coverage
- gram(-) → PSA, E. coli, klebsiella
gentamicin & tobramycin dosing
2 mg/kg/dose IV Q8H
gentamicin & tobramycin peak & trough goals
peak: ≤10 mcg/mL
trough: <2 mcg/mL
AMGs clinical pearls
- BBW: neuro/nephro/ototoxicity
- nephro is reversible
- oto is irreversible
- preg cat C/D
amikacin dosing
7.5mg/kg/dose IV Q8H
amikacin peak & trough goals
peak: ≤30 mcg/mL
trough: <5 mcg/mL
Zemdril
plazomicin
Vancocin
vancomycin
vancomycin coverage
PO for C.diff
IV for MRSA
vancomycin dosing
- 15mg/kg or 500mg-2g/day divided Q6-12H
- dilute to max 5mg/mL
- CrCl 40-79: Q24H
- CrCl 25-39: Q48H
- CrCl <25: check trough
vancomycin peak & trough goals
peak: ≤40 mcg/mL [>80 mcg/mL is toxic]
trough: <10 mcg/mL [20 for severe ifx]
vancomycin clinical pearls
- nephro/ototoxicity
- DNU w/ other nephro/ototoxic drugs → MAGs, ampB
- rates >15mg/min = red man syndrome
- preg cat C
chloramphenicol clinical pearls
- BBW: blood dyscrasias → can induce rare and irreversible bone marrow suppression
- must monitor CBC
- SE: gray syndrome of neonates
UTI trx
- fosfomycin [Monurol]
- sulfamethoxazole & trimethoprim [Bactrim, Septra]
- nitrofurantoin [Macrobid, Macrodantin]
others:
- fluoroquinolones → cipro or levo
- beta-lactams [less efficacy] → amoxil, augmentin, keflex, rocephin
- methenamine [UREX]
UTI ppx
- methenamine [UREX] → to prevent recurrent UTIs
- cranberry juice may potentially prevent
UTI symptoms trx
phenazopyridine [Azo, Uristat, Pyridium]
- urinary analgesic
UTI trx for pregnant pts
- treat for 7 days to prevent premature birth
- beta-lactams & fosfomycin
- nitrofurantoin ok before 37 weeks
- phenazopyridine for symptoms
Monurol
fosfomycin
Bactrim/Septra
SMX/TMP
Macrobid
nitrofurantoin monohydrate macrocrystal
Macrodantin
nitrofurantoin macrocrystal
fosfomycin dosing
3g x1
fosfomycin clinical pearls
diarrhea
SMX/TMP dosing
- SS: 400mg SMX/80mg TMP
- DS: 800mg SMX/160mg TMP [5:1 ratio]
- adults: DS tab BID
SMX/TMP clinical pearls
- take with food
- caution w/ sulfa allergy
- preg cat C
- do NOT refrigerate
- short stability [6 H]
- protect from light when undiluted
- D5W only!!
- crystalluria → hydrate to prevent kidney stones
- photosensitivity
- 2C8/9 inhibitors → increases INR
- serious skin rashes
- watch for blood dyscrasias
- don’t give in G6PD deficiency
- adjust dose for CrCl <30 mL/min
nitrofurantoin clinical pearls
- take with food
- interacts with Mg antacids
- dark urine color
- serious lung problems & C.diff
- preg cat D near term
nitrofurantoin dosing
macrobid: 100mg BID
macrodantin: 100mg QID
methanamine clinical pearls
- 1g BID
- avoid alkalinizing foods/meds
- urinary antiseptic
- monitor liver function
- preg cat C
phenazopyridine clinical pearls
- 200mg TID [Rx]
- 100mg TID [OTC] x2 days
- urinary analgesic
- Azo dye → red-orange urine
latent TB trx
- INH + rifapentine once weekly x3 months
- rifampin QD x4 months
- INH + rifampin QD x3 months
active TB trx
- rifampin + INH + pyrazinamide + ethambutol x26 weeks [initial phase]
- rifampin + pyrazinamide + ethambutol +/- FQ x6 months [if resistance to INH]
- INH + ethambutol + FQ + pyrazinamide [x 2mo] x12-18 mo → if resistance to RIF
drug-resistant TB abx
pretomanid
isoniazid clinical pearls
- hepatoxic
- tk on empty stomach
- BBW: fatal hepatitis
- neurotoxic → add Vit B6 [pyridoxine] to prevent neuropathy
- lupud/flu-like symptoms
- P-450 inhibitor
Rifadin
rifampin
Priftin
rifapentine
Myambutol
ethambutol
rifampin clinical pearls
- orange urine/body fluids
- flu-like syndrome
- CYP3A4 inducers → decreased bioavailability & increased clearance of coadministered meds [decrease efficacy of oral contraceptives]
rifapentine clinical pearls
- orange urine/body fluids
- allergy rxn & flu-like syndrome
- decreased WBC & RBC!!
- CYP3A4 inducers → decreased bioavailability & increased clearance of coadministered meds [decrease efficacy of oral contraceptives]
ethambutol clinical pearls
- optic neuritis → monthly vision tests
Amphocin
amp B infusion
- for life-threatening fungal ifx
Abelcet
ampB lipid complex
AmBisome
liposomal ampB
ampB clinical pearls
- preg cat B
- decreased K+ → enhances digoxin toxicity
- decreased Mg2+
- nephrotoxicity → DNU w/ cyclosporin, AMGs, flucytosine, cisplatin
- D5W only
- pre-medicate for infusion-related rxn
Ancobon, 5-FC
flucytosine
flucytosine clinical pearls
- converts to fluorouracil
- causes bone marrow suppression
- avoid monotherapy d/t rapid resistance
Cancidas
caspofungin
caspofungin dosing
500mg IV QD
NS only!!!
Mycamine
micafungin
mycamine dosing
100mg IV QD
azole antifungals
- ketoconazole [Nizoral]
- fluconazole [Diflucan]
- itraconazole [Sporanox]
- voriconazole [Vfend]
- posaconazole [Noxafil]
- isavuconazonium [Cresembra]
Nizoral
ketoconazole
Diflucan
fluconazole
Sporanox
itraconazole
Vfend
voriconazole
Noxafil
posaconazole
Cresemba
isavuconazonium
ketoconazole dosing
400mg QD
ketoconazole clinical pearls
- BBW: hepatotoxicity
- need acidic pH for absorption → avoid using with antacids, H2RAs, PPIs
fluconazole dosing
400mg QD
fluconazole IV to PO
IV:PO = 1:1
fluconazole clinical pearls
- single dosing: 150mg tab x1
- if taken longer, counsel on possible hepatotoxicity or serious skin rash
itraconazole dosing
400mg QD
itraconazole clinical pearls
- BBW: heart failure
- note: oral caps & oral sol → CANNOT use interchangeably
- caps need food [gastric acidity] for absorption
- sol can take on empty stomach
- need acidic pH for absorption → avoid antacids, H2RAs, PPIs
Mycostatin
Nystatin
oral yeast ifx trx
- Rx only!!
- TOP: nystatin susp 4-5x daily [swish & swallow] or clotrimazole lozenges
- PO: fluconazole or itraconazole
Mycelex
clotrimazole
vaginal candida ifx trx
PO [Rx]:
- fluconazole 150mg PO x1 [can repeat] and itraconazole → increased resistance from azoles
- ibrexafungerp [Brexafemme] 150mg - 2 pills AM & 2 pills PM
INTRAVAGINAL/TOP [OTC]: 1, 3, 7(14) day regimens
- safe for pregnancy
- clotrimazole [Gyne-Lotrimin-7, Mycelex-7]: 1% cream x7 days, supp 100mg x7 days
- miconazole [Monistat-1, Monistat-3, Monistat-7]: supp 1.2g x1, 200mg x3 days or 100mg x7 days
- nystatin vaginal insert [Mycostatin]: 100,000 units QD x14 days
- butoconazole [Femstat-3, Gynazole-1]: 2% cream 5g x1-3 days
- tioconazole [Vagistat-1]: 6.5% oint 5g x1
- terconazole cream [Terazol]: 0.4% cream x7 days, 0.8% cream x3 days, supp [Zazole] 80mg x3 days
Brexafemme
ibrexafungerp
Gyne-Lotrimin-7, Mycelex-7
clotrimazole
Monistat
miconazole
Mycostatin
nystatin vaginal insert
Femstat-3, Gynazole-1
butoconazole
Vagistat-1
tioconazole
Terazol
terconazole cream
Zazole
terconazole supp
HSV-1 vs HSV-2
HSV-1: oropharyngeal [cold sores or fever blisters]
HSV-2: genital
HSV trx
- Rx: acyclovir [Zovirax], valacyclovir [Valtrex], penciclovir [Denavir]
- works best taken at 1st sign of outbreak within 1st day
- PO: 200mg 2-5 times QD [drink lots of fluid]
- cream: 6 times/day x7 days
- valacyclovir: 2g BID x1 day for herpes labialis
- use foscarnet if resistant to acyclovir/valacyclovir/famciclovir
cytomegalovirus trx
- ganciclovir [Cytovene, Cymevene, Vitrasert ocular]
- valganciclovir [Valcyte]
- cidofovir [Vistide]
- foscarnet [Foscavir]
which abx has been clinically shown to decrease effectiveness of birth control pills
rifampin
abx for PSA
- AMGs
- beta-lactams: cefepime, ceftazidime, zosyn, ticarcillin-clavulanate
- aztreonam
- carbapenems: imi, mero, dori
- FQ: cipro, levo
abx during pregnanct
- beta-lactams: PCNs, cephalosporins & carbapenems [no imi]
- clindamycin
- macrolides: azithro, erythro [NO claritho]
- flagyl ok for bacterial vaginosis or vaginal trichomoniasis
oral abx susp that should not be refrigerated
- azithromycin
- clarithromycin
- clindamysin
- FQs
- voriconzole
C.diff ifx trx
- vanco PO [Firvanq] 125mg QID [500mg QID with flagyl IV if severe/complicated] AND/OR
- fidaxomicin [Dificid] 200mg tab BID x10 days
- alt: flagyl
- bezlotoxumab [Zinplava]: human mAb that neutralized effect of C.diff → 10 mg/kg IV x1 w/ abx
abx ped dosing
- amox: 50mg/kg [max 2g]; susp = 50mg/mL
PCN allergy:
- clindamycin 20mg/kg [max 600mg]
- azithromycin 15mg/kg [max 500mg]
- clarithromycin 15mg/kg [max 500mg]
Zovirax
acyclovir
Valtrex
valacyclovir
Denavir
penciclovir
Famvir
famciclovir
Cytovene, Cymevene
ganciclovir
Vitrasert
ganciclovir ocular
Valcyte
valganciclovir
Vistide
cidofovir
Foscavir
foscarnet
Firvanq
vanco PO
Dificid
fidaxomicin
Zinplava
bezlotoxumab
malaria ppx regimen
start 1-2 days prior to travel & continue QD until 7 days after travel
- atovaquone-proguanil [Malarone]
- primaquine: CI w/ G6PD deficiency
need to be taken for 4 weeks after travel:
- chloroquine [weekly]: if on hydroxychloroquine, don’t need additional meds
- mefloquine [Lariam]: weekly; CI in neuro/psych disorders
- doxycycline: daily
malaria trx regimen
chloroquine-resistant:
- atovaquone-proguanil [Malarone] x3 days
- artemether-lumefantrine [Coartem] x3 days
- quinine x3-7 days PLUS doxy, tetra or clinda x7 days
- mefloquine [Lariam]
- sulfadoxine-pyrimethamine [Fansidar]
chloroquine-sensitive:
- chloroquine [Aralen]: 600mg base PO + 300mg base PO at 6, 24, 28 hours
- hydroxychloroquine [Plaquenil]
- primaquine
severe malaria:
- artesunate IV then malarone, doxy [clinda if preg] or mefloquine
pregnant:
- chloroquine phosphate OR hydroxychlorouine, quinine + clinda, OR mefloquine
- tafenoquine [Krintafel] for prevention of relapse of p. vivax ifx
quinine clinical pearls
- SE: cinchonism
- overdosage may lead to cardiotoxicity
- monitor for hypoglycemia
sulfadoxine-pyrimethamine clinical pearls
- SE: bone marrow suppression, hemolysis with G6PD deficiency
- sulfa allergy
hydroxychloroquine clinical pearls
- SE: toxicity in eye w/ chronic use
Malarone
atovaquone-proguanil
Lariam
mefloquine
Coartem
artemether-lumefantrine
Fansidar
sulfadoxine-pyrimethamine
Aralen
chloroquine
Plaquenil
hydroxychloroquine
Krintafel
tafenoquine
normal BP
<120/80 mmHg
elevated BP
SBP 120-129 AND DBP <80
stage 1 HTN
SBP 130-139 OR DBP 80-90
stage 2 HTN
SBP ≥140 OR DBP ≥90
thiazide diuretics clinical pearls
- diuretics of choice → if NO renal impairment
- SULFA drugs → photosensitivity rash
- metolazone ok if renal dysfunction
Diuril
chlorothiazide
Microzide
HCTZ
Hydrodiuril
HCTZ
Dyazide
HCTZ + triamterene
Maxzide
HCTZ + triamterene
Thalidone
chlorthalidone
Hygroton
chlorthalidone
Zaroxolyn
metolazone
Lozol
indapamide
chlorothiazide target dose
500mg
HCTZ target dose
50mg
chlorthalidone target dose
25mg
metolazone target dose
20mg
indapamide target dose
2.5mg
which diuretics cause metabolic alkalosis
thiazides & loops
which diuretics cause metabolic acidosis
K+ sparing & aldosterone antagonists
metabolic alkalosis
decrease:
- K+ [hypokalemia]
- Na+ [hyponatremia]
- Mg2+
increase:
- BG, TG, TC, UA
monitor: diabetes & gout
thiazides: increase Ca2+
loops: decrease Ca2+ [decrease bone density]
Lasix
furosemide
Demadex
torsemide
Bumex
bumetanide
Edecrin
ethacrynic acid
loop diuretics clinical pearls
- SULFA drugs → photosensitivity, rash
- diuretics of choice if renal disease
- increase fluid depletion → for edema in HR & need K+ supp
- IV is light sensitivity & can cause ototoxicity
- Edecrin: avoid with AMGs
furosemide target dose
40mg BID
bumetanide target dose
1mg BID
torsemide target dose
10mg QD
ethacrynic acid target dose
25-50mg
ok for sulfa allergy
oral loop dose equivalency
furo 40mg = tor 20mg = bume 1mg
Dyrenium
triamterene
triamterene target dose
300mg
Midamor
amiloride
amiloride target dose
20mg
aldosterone antagonists clinical pearls
- SE: gynecomastia [spironolactone only]
- for HF & HTN
- CI in pregnancy
- tk spironolactone w/ food
Aldactone
spironolactone
Carospir
spironolactone
Inspra
eplerenone
spironolactone target dose
25-50mg
eplerenone target dose
25-50mg
metabolic acidosis
- monitor: increased K+, decreased Ca2+, gout
- CI if CrCl <30 mL/min
ACE-I & ARB clinical pearls
- BBW: CI in pregnancy & bilateral renal artery stenosis [drops glomerular perfusion pressure]
- metabolic acidosis
- can increase K+
- AE: dry cough [mainly ACE-I], HA, dizziness, angioedema [esp black pts]
- well tolerated, no need to take w/ food
- monitor renal function → 1st line in CKD bc antihypertensive & anti-inflammatory
- avoid combo w/ NSAIDs
why can’t lithium be given with diuretics
diuretics decrease lithium’s renal clearance & increase toxicity
what can licorice cause in large amounts
increase BP, salt and water retention, & decrease K+ levels
Lotensin
benazepril
Capoten
captopril
Vasotec
enalapril
Enalaprilat
injectable enalapril
Monopril
fosinopril
Zestril
lisinopril
Prinivil
lisinopril
Prinzide
lisinopril + HCTZ
Zestorectic
lisinopril + HCTZ
Univasc
moexipril
Accupril
quinapril
Altace
ramipril
Mavik
trandolapril
target dose of benazepril
40mg
target dose of captopril
50mg TID
target dose of enalapril
40mg
target dose of fosinopril
40mg
target dose of lisinopril
40mg
target dose of moexipril
30mg
target dose of quinapril
40mg
target dose of ramipril
10mg
trandolapril
4mg
Atacand
candesartan
Teveten
eprosartan
Avapro
irbesartan
Avalide
irbesartan + HCTZ
Cozaar
losartan
Hyzaar
losartan + HCTZ
Diovan
valsartan
Benicar
olmesartan
Micardis
telmisartan
Edarbi
azilsartan
candesartan target dose
32mg
eprosartan target dose
800mg
irbesartan target dose
300mg
losartan target dose
100mg
valsartan target dose
320mg
olmesartan target dose
40mg
telmisartan target dose
80mg
azilsartan target dose
80mg
what are beta-blockers CI in
- diabetes
- asthma & COPD
- bradycardia
- heart block
- caution in unstable F & peripheral vascular disease
beta-blockers side effects
- dyslipidemia & weight gain
- fluid retention
- fatigue, depression, decreased libido
- dizziness → tk w/ food
- don’t d/c abruptly
beta-blocker indications
- HTN → 2nd line
- post-MI
- angina
- tachyarrhythmias
- stable HF
- migraine & glaucoma
cardioselective beta-blockers
beta-1 selective [excitatory heart]
BE A MAN
Tenormin
atenolol
Tenoretic
atenolol + chlorthalidone
Lopressor
metoprolol tartrate IR
Toprol
metoprolol succinate ER
Brevibloc
esmolol → IV for HTN emergency
Zebeta
bisoprolol
Ziac
bisoprolol + HCTZ
Kerlone
betaxolol
Betoptic
betaxolol for glaucoma
Sectral
acebutolol
Bystolic
nebivolol → increases nitric oxide production
max dose of atenolol
100mg
max dose of metoprolol
- 25-200mg
- HTN: 400mg/d
- HF: HF 200mg/d
max dose of bisoprolol
10mg
max dose of betaxolol
40mg
max dose of acebutolol
400mg BID
max dose of nebivolol
40mg
non-selective beta-blockers
- b-1 & b-2 blockers
- b-2: bronchodilators
Inderal LA, InnoPran
propranolol → tk w/ food
propranolol max dose
IR 80mg BID
ER QD
Blocadren
timolol
Timoptic
timolol → glaucoma
timolol max dose
40mg BID
Visken
pindolol
pindolol max dose
40mg BID
Corgard
nadalol
nadalol max dose
320mg
Levatol
penbutolol
penbutolol max dose
80mg
Cartrol
carteolol
carteolol max dose
10mg
Ocupress
carteolol → glaucoma
Normodyne
labetalol → tk w/ food
Trandate
labetalol → tk w/ food
labetalol max dose
800mg BID [2400mg/d]
Coreg
carvedilol → tk w/ food
carvedilol max dose
IR: 50mg BID
ER: 80mg QD
3.125-6.25-12.5-25mg tabs
Cardizem
diltiazem
Calan
verapamil
Isoptin
verapamil
Verelan
verapamil
Covera
verapamil
non-DHP CCB clinical pearls
- more negative inotropic effects → BRADYCARDIA
- CI in 2-3rd AV block, acute MI, BB use
- effective for arrhythmias
- preferred for CKD & diabetic nephropathy
- SE: gingival hyperplasia, constipation
- CYP3A4 DDIs
DHP CCB clinical pearls
- more potent vasodilators → reflex TACHYCARDIA
- ok with BBs but CI if acute mI
- ineffective for arrhythmias
- SE: HA, flushing, edema of ankle
- no significant DDIs
Norvasc
amlodipine
Katerzia
amlodipine PO susp
Lotrel
amlodipine + benazepril
Exforge
amlodipine + valsartan
Azor
amlodipine + olmesartan
Plendil
felodipine ER
DynaCirc
isradipine CR
Cardene
nicardipine
Adalat CC
nifedipine ER
Procardia XL
nifedipine ER
Sular
nisoldipine
alpha-1 blockers clinical pearls
- syncope d/t orthostatic HoTN after initial dose, dizziness, fatigue
- titrate
- mainly for BPH
- for HTN: doxazosin, terazosin, prazosin
Cardura
doxazosin
Hytrin
terazosin
Minipress
prazosin
Flomax
tamsulosin
Uroxatral
alfuzosin
Rapaflo
Silodosin
alpha-2 agonist clinical pearls
- caution: bradycardia, dry mouth, fatigure, depression, psychotic rxn, impotence, rebound HTN
- clonidine for resistance HTN & pts who can’t swallow
- clonidine off-label for opioid withdrawal, anxiety & sleep
- methyldopa SE: lupus-like symptoms, hepatitis, myocarditis, hemolytic anemia
Catapres
clonidine
clonidine dosing
- 0.1-0.3mg BID
- patch is weekly
Aldomet
methyldopa
methyldopa dosing
500mg BID [max 3000mg/day]
Wytensin
guanabenz
Tenex
guanfacine
direct vasodilators clinical pearls
- caution: reflex tachycardia
- hydralazine: lupus like symptoms
- minoxidil: hair growth
adrenergic neuron blockers clinical pearls
- caution: bradycardia, depression
Apresoline
hydralazine
Loniten
minoxidil
Serpasil
Reserpine
reserpine dosing
0.05-0.25mg
IV agents for hypertensive crisis
- hydralazine
- NTG [Tridil] → absorbs into plastic, DNU PVC
- labetalol, esmolol
- enalaprilat
- clonidine
- phentolamine [Regitine]
- nitroprusside [Nipride] → most effective
- nicardipine
HTN in pregnancy
- 1st line: methyldopa & labetalol
- 2nd line: hydralazine, nifedipine & BBs
STEMI trx
- fibrinolysis [<30 min or when can’t do PCI within 90 min]
- primary PCI [<90 min] → angioplasty or stent
- LD: P2Y12-i
NSTEMI & UA trx
- MONA
- IV anti-thrombotics → GPIIb/IIIa-i, antiplatelets [P2Y12-i], anticoagulants [heparin, LMWH]
t-PA, Activase
alteplase
r-RA, Retavase
reteplase
TNK-tPA
tenecteplase
Streptase
streptokinase
Abbokinase
urokinase
Reopro
abciximab
conversion between carvedilol IR and ER
Coreg CR 10mg QD = Coreg 3.125mg BID
Coreg CR 20mg QD = Coreg 6.25mg BID
Coreg CR 40mg QD = Coreg 12.5mg BID
Coreg CR 80mg QD = Coreg 25mg BID
ACS discharge meds
- aspirin 81mg indefinitely
- DAPT w/ P2Y12-i for ≥1 year
- warfarin if persistent AF
- ACE-I/ARB if LVEF <40%
- beta-blocker
- statin is LDL >100
- NTG
Aggrastat
tirofiban
Integrilin
eptifibatide
Ticlid
ticlopidine
Plavix
clopidogrel
Effient
prasugrel
Kengreal IV
cangrelor
IV antithrombotics
- abciximab [Reopro]
- tirofiban [Aggrastat]
- eptifibatide [Integrilin]
abciximab clinical pearls
- PCI only
- NOT reversible
- dose: 0.25mg/kg bolus before PCI Then 0.125mcg/kg/min x12 hours
- ADE: thrombocytopenia, bleeding & HoTN
- monitor: Hct/hgb, platelets, PT/aPTT, ACT
- not renally adusted
Brilinta
ticagrelor
tirofiban clinical pearls
- ACS
- reversible
- dose: 0.4 mcg/kg/min x30 min then 0.1mcg/kg/min x24 H after PCI
- ADE: thrombocytopenia, bleeding & HoTN
- monitor: Hct/hgb, platelets, PT/aPTT, ACT
- renally adjust
which P2Y12-i is only indicated for PCI
prasugrel
eptifibatide clinical pearls
- ACS + PCI
- reversible
- dose: 180 mcg/kg bolus then 2mcg/kg/min x24H
- protect from light, refrigerate
- ADE: thrombocytopenia, bleeding & HoTN
- monitor: Hct/hgb, platelets, PT/aPTT, ACT
- renally adjusted
irreversible P2Y12-is
- clopidogrel
- ticlopidine
- prasugrel
clopidogrel dosing
LD: 300-600mg
MD: 75mg QD
reversible P2Y12-is
- cangrelor
- ticagrelor
prasugrel dosing
LD: 60mg
MD: 10mg QD
when do antithrombotics have to be d/c’ed before surgery
5-7 days
ticagrelor dosing
LD: 180mg LD
MD: 90mg BID
Jantoven
warfarin
Coumadin
warfarin
Pradaxa
dabigatran
DTI
Bevyxxa
betrixaban
Factor Xa inhibitor
Innohep
Tinzaparin
LMWH
warfarin clinical pearls
- BBW: fatal bleeding, skin necrosis, purple toe, DDIs
- hepatically cleared
- preg cat X
- reversal: vit K, PCC, frozen plasma
Eliquis
apixaban
Factor Xa inhibitor
heparin clinical pearls
- SC for ppx
- IV for trx
- no renal adjustment
- reversal: protamine
Andexxa
Andexanet-alfa
LMWH clinical pearls
- no routine monitoring
- lovenox trx: 1mg/kg SC BID
- lovenox ppx: 40mg SC QD
- renally adjusted
- reversal: protamine
fondaparinux clinical pearls
- ppx: 2.5mg SC
- trx: 5-10mg SC
- no routine monitoring
- renal adjustment → CI if CrCl <30
- reversal: Andexxa
Praxbind
idarucizumab
edoxaban clinical pearls
- 60mg PO QD
- no routine monitoring
- renal adjust → 30mg QD
- stroke ppx in NVAF, DVT/PE
- reversal: andexxa
warfarin colors
1mg - pink
2mg - lavender
2.5mg - green
3mg - brown
4mg - blue
5mg - peach
6mg - teal
7.5mg - yellow
10mg - white
xarelto clinical pearls
- dose: 20mg PO QD
- renal adjust → 15mg QD
- for stroke ppx in nonvalvular AFib, DVT/PE, surgical ppx
what can increase INR
- ginger
- gingko
- garlic
- anti-inflammatory agents
- antibiotics
- antidepressants
- antiplatelets
- azoles
- CYP2C9 inhibitors
what can decrease INR
- ginseng
- green tea
- soya
- SJW
- vit K
- CYP2C9 inducers
class I antiarrhythmias
*PROLONG QT INTERVAL
- quinidine
- procainamide
- disopyramide
antithrombotic for Afib
- dabigatran
- rivaroxaban
- apixaban
- warfarin
rate controllers for afib
- beta-blockers
- non-DHP CCBs
- digoxin
Norpace
disopyramide
quinidine clinical pearls
- tk w/ food to decrease GI upset
- BBW: increased mortality. thrombocytopenia [monitor CBC]
- SE: diarrhea, strong anticholinergic → cinchonism
- DDIs: digoxin [decrease digoxin 50%], warfarin [increase INR]
Fragmin
dalteparin
LMWH
Lovenox
enoxaparin
LMWH
Arixtra
fondaparinux
Factor Xa inhibitor
Xarelto
rivaroxaban
Factor Xa inhibitor
Savaysa
edoxaban
Factor Xa inhibitor
class II antiarrhythmics
beta-blockers
- esmolol
- propranolol
Cordarone
amiodarone
Tikosyn
dofetilide
class III antiarrhythmics
*INCREASE QT INTERVAL
- amiodarone
- dofetilide
- dronedarone
- ibutilide
- sotalol
Multaq
dronedarone
Corvert
ibutilide
amiodarone clinical pearls
- broad spectrum antiarrhythmic, safe in HR & post MI
- only for life-threatening arrhythmias
- D5W only
- SE: vision changes/corneal microdeposits, photosensitivity, HoTN, bradycardia, dizziness, tremor, slate blue skin
- monitor thyroid, liver, lungs
- use lower doses of digoxin, warfarin, quinidine, procainamide, simvastatin, lovastatin, atorvastatin
class IV antiarrhythmics
non-DHP CCBs
- verapamil
- diltiazem
Adenocard
adenosine
Betapace
sotalol
Lanoxin
digoxin
digoxin therapeutic range for AF
0.5-2 ng/mL
Digitek
digoxin
digoxin therapeutic range for HF
0.5-0.9 ng/mL
drugs that increase QT
- class Ia antiarrhythmics
- class III antiarrhythmics
- quinolones
- macrolides
- amantadine
- foscarnet
- azoles
- PIs
- APs, SSRIs, TCAs, SNRIs, trazodone
- 5-HT3 inhibitors & droperidol
- alfuzosin
- apomorphine
- chloroquine
- galantamine
- methadone
- pentamidine
angina trx
- aspirin
- antianginal: beta-blockers, CCBs [Prinzmetal], nitrates, ranolazine
Nitro-Bid
NTG ointment 2%
Nitro-Dur
NTG patch
Minitran
NTG patch
Tridil
NTG IV → D5W
NitroMist
NTG spray
Nitrostat
NTG sublingual tab
Monoket
isosorbide mononitrate IR
Nitrolingual
NTS spray
Ismo
isosorbide mononitrate IR
Nitro-Time
NTG extended release
Dilatrate-SR
isosorbide dinitrate
- decrease mortality in HF
Imdur ER
isosorbide mononitrate ER
Ranexa
ranolazine
Isordil
isosorbide ditrate
- decreases mortality in HF
HF trx
- 1st line: ARNI/ACE-I/ARB + beta-blocker + MRA + SGLT2-i
- hydralazine + isosorbide dinitrate 1st line in african americans
- diuretics as needed
- additional: ivabradine, vericiguat, digoxin, potassium binder, digoxin
procainamide clinical pearls
- tk on empty stomach
- BBW: agranulocytosis
disopyramide clinical pearls
- tk on empty stomach
- SE: HF, anticholinergic effects
class Ib antiarrhythmics
- lidocaine
- mexiletine
Xylocaine
lidocaine
class Ic antiarrhythmics
- flecainide
- propafenone
*not in use
which statins do you take at bedtime
fluva, lova ER & simva
lipophilic statins
atorva, lova, simva, fluva, pitava
- higher risk for muscle pain
Mevacor IR
lovastatin IR → tk with dinner
Lescol
fluvastatin
Altoprev ER
lovastatin ER → tk QHS
hydrophilic statins
rosu, prava
- lower risk for muscular side effects
Lipitor
atorvastatin
Pravachol
pravastatin
Zocor
simvastatin → tk QHS
Crestor
rosuvastatin
Livalo
Pitavastatin
Niacor
niacin OTC → tk w/ food
Niaspan ER
niacin ER → tk QHS after low-fat snack
Nexletol
bempedoic acid
ATP citrate lyase inhibitor
Juxtapid
lomitapide
MTTP inhibitor
Evkeeza
evinacumab-dgnb
angiopoietin-like 3 inhibitor
Nexlizet
bempedoic acid/ezetimibe
ATP citrate lyase inhibitor
Zetia
ezetimibe
Colestid
colestipol
bile-acid binding resins
Vytorin
ezetimibe + simvastatin
Welchol
colesevelam
bile-acid binding resins
Questran, Prevalite, LoCholest
cholestyramine
bind-acid binding resins
Tricor
fenofibrate
Lopid
gemfibrozil → better not w/ statins
Lipofen
fenofibrate
Trilipix
fenofibrate
Repatha
evolocumab
PCSK9-i mAb
Leqvio
inclisiran
siRNA
Praluent
alirocumab
PCSK9-i mAb
Antara
fenofibrate
Humalog
insulin lispro
rapid-acting
Triglide
fenofibrate
Corlanor
ivabradine
Verquvo
vericiguat
antidote for digoxin
Digibind or Digifab
what is tafamadis indicated for
transthyretin amyloid → reduce CV morbidity & mortality
lipid panel goals
LDL <100
TG <15
HDL ≥60
TC <200
cholesterol guidelines
- statins 1st line
- pts w/ clinical ASCVD: high-intensity statin
- high-intensity statin: lipitor 40-80mg & crestor 20-40mg
Lyumjev
insulin lispro
rapid-acting
Novolog
insulin aspart
rapid-acting
Fiasp
insulin aspart
rapid-acting
*has niacinamide
Admelog
insulin lispro
rapid-acting
Apidra
insulin glulisine
rapid acting
Humulin R
insulin regular
short-acting
Ozempic
semaglutide
GLP-1 agonist
Rybelsus
semaglutide PO
GLP-1 agonust
Novolin R
insulin regular
short-acting
Januvia
sitagliptin
DPP4-i
Onglyza
saxagliptin
DPP4-i
Tradjenta
linagliptin
DPP4-i
Micronase
glyburide
SU
Diabeta
Glyburide
SU
Glucotrol
glipizide
SU
Amaryl
glimepiride
SU
Prandin
repaglinide
meglitinide
Starlix
nateglinide
meglitinide
Actose
pioglitazone
TZD
Fortamet
metformin
Avandia
rosiglitazone
TZD
Glucophage
metformin
Precose
acarbose
alpha-glucosidase inhibitor
Glumetza
metformin
Farxiga
dapagliflozin
SGLT2-i
Invokana
canagliflozin
SGLT2-i
Glyset
miglitol
alpha-glucosidase inhibitor
Steglatro
ertugliflozin
SGLT2-i
Xigduo XR
dapagliflozin + metformin
Segluromet
ertugliflozin + metformin
Invokamet
canagliflozin + metformin
Jardiance
empagliflozin
SGLT2-i
Kazano
alogliptin + metformin
Glyxambi
empagliflozin + linagliptin
Kerendia
finerenone
nonsteroidal MRA
Oseni
alogliptin + pioglitazone
Lyxumia
lixisenatide
Trijardy XR
empagliflozin + linagliptin + metformin
Steglujan
sitagliptin + ertugliflozin
Humulin N
insulin NPH
intermediate acting
Toujeo
insulin glargine
long acting
Semglee
insulin glargine
long acting
Lantus
insulin glargine
long-acting
Novolin N
insulin NPH
intermediate acting
NovoLog Mix 70/30, 50/50
aspart protamine susp/aspart
Humulin 70/30, 50/50
NPH/regular
Novolin 70/30
NPH/regular
Symlin
pramlintide
amylin analog
Levemir
insulin detemir
long acting
Humalog Mix 75/25, 50/50
lispro protamine susp/lispro
insulin secretagogues
sulfonylureas [longer-acting]
meglitinides [rapid-acting]
Victoza
liraglutide
GLP-1 agonist
Byetta, Bydureon
exenatide
GLP-1 agonist
peptide analogs
GLP-1 agonists
DPP4-i
pramlintide
insulin sensitizers
glitazones
biguanides
Tanzeum
albiglutide
Juvisync
sitagliptin + simvastatin
Trulicity
dulaglutide
Cycloset
bromocriptine
Neupogen
filgrastim
+granulocytes
Nyvepria
pegfilgrastim
+ granulocytes
Neulasta
pegfilgrastim
+ granulocytes
Ziextenzo
pegfilgrastim
+ granulocytes
Fulphila
pegfilgrastim
+ granulocytes
Procrit
epoetin
+ RBC
Epogen
epoetin
+ RBC
Retacrit
epoetin
+ RBC
Aranesp
darbepoetin
+ RBC
Neumega
oprelvekin
+ platelets
Leukine
sargramostim
+ macrophages
trx for macrocytic anemia
- vit B12
- folic acid
trx for microcyctic anemia
iron
trx for normocytic anemia
ESAs
Intron A
interferon alpha-2b
HCV
Mavyret
glecaprevir + pibrentasvir
Daklinza
daclatasvir
NS3 protease inhibitors for HCV3
- simeprevir
- paritaprevir
- grazoprevir
Harvoni
sofosbuvir + ledipasvir
Epclusa
sofosbuvir + velpatasvir
Sovaldi
sofosbuvir
NS5A inhibitors for HCV
- ledipasvir
- ombitasvir
- daclatasvir [Daklinza]
- elbasvir
- velpatasvir [Epclusa, Sofosvel, Velpanat]
- glecaprevir
Vosevi
sofosbuvir + velpatasvir + voxilaprevir
Retrovir
zidovudine
NRTI
Ziagen
abacavir
NRTI
Epivir
lamivudine
NRTI
Exviera
dasabuvir
NS5B NNI inhibitor
Rubokia
fostemsavir
NRTI
Combivir
zidovudine + lamivudine
NRTI + NRTI
Pegasys
PEG-IFN alfa-2a
HCV
Rebetol
ribavirin
Peg-Intron
PEG-IFN alfa-2b
HCV
Copegus
ribavirin
ribavirin clinical pearls
- BBW: hemolyti anemia
- preg cat X [2 forms birth control + pregnancy test]
Zepatier
grazoprevir + elbasvir
NS3 PI
Olysio
simeprevir
NS3 PI
- tk with food
- combo with PEGIFN-RBV or sofosbuvir
Epzicom
abacavir + lamivudine
NRTI + NRTI
Trizivir
abacavir + zidovudine + lamivudine
NRTI + NRTI + NRTI
Cimduo
TDF + lamivudine
NRTI + NRTI
Viread
TDF
- oral powder: tk w/ food
NRTI
Truvada
TDF + emtricitabine
NRTI + NRTI
Videx EC
didanosine
*on empty stomach
NRTI
Descovy
TAF + emtricitabine
NRTI + NRTI
Emtriva
emtricitabine
NRTI
Tybost
cobicistat
PK enhancer
Kaletra
ritonavir + lopinavir
PI
Invirase
saquinavir
*take with Norvir [ritonavir]
*take w/ food
PI
Norvir
ritonavir
*take w/ food
PI
booster
Prezista
darunavir
*sulfa allergy
*take w/ food
PI
Reyataz
atazanavir
*take w/ food
PI
Evotaz
atazanavir + cobicistat
Crixivan
indinavir
*empty stomach
PI
Aptivus
tipranavir
*sulfa allergy
*take w/ food
PI
Zerit
stavudine
NRTI
Cabenuva
cabotegravir + rilpivirine
INSTI + NNRTI
Viracept
nelfinavir
*take w/ food
PI
Lexiva
fosamprenavir
*sulfa allergy
PI
Rescriptor
delavirdine
NNRTI
Pifeltro
doravirine
NNRTI
Edurant
rilpivirine
*take w/ food
NNRTI
Intelence
etravirine
*take w/ food
NNRTI
Viramune
nevirapine
NNRTI
Sustiva
efavirenz
*empty stomach
NNRTI
Fuzeon
enfuvirtide
entry inhibitor
Tivicay
dolutegravir
INSTI
Isentress
raltegrevir
INSTI
Atripla
efavirenz + TDF + emtricitabine
*empty stomach
NNRTI + NRTI + NRTI
Symfi
efavirenz + TDF + lamivudine
*empty stomach
NNRTI + NRTI + NRTI
Selzentry
maraviroc
entry inhibitor
Vitekta
elvitegravir
*take with food
*take with other PIs
INSTI
Complera
rilpivirine + TDF + emtricitabine
*take w/ food
NNRTI + NRTI + NRTI
Stribild
elvitagrevir/cobicistat + TDF + emtricitabine
*take w/ food
INSTI + NRTI + NRTI
Triumeq
dolutegravir + abacavir + lamivudine
INSTI + NRTI + NRTI
Dovato
dolutegravir + lamivudine
INSTI + NRTI
Symtuza
darunavir/cobicistat + emtricitabine + TAF
*take w/ food
PI + NRTI + NRTI
Delstrigo
doravirine + lamivudine + TDF
NNRTI + NRTI + NRTI
Odefsey
emtricitabine + rilpivirine + TAF
*take w/ food
NRTI + NNRTI + NRTI
Genvoya
elvitegravir/cobicistat + emtricitabine + TAF
*take w/ food
INSTI + NRTI + NRTI
Biktarvy
bictegravir + emtricitabine + TAF
INSTI + NRTI + NRTI
Celexa
citalopram
SSRI
max 40mg/d bc QT
PEP regimen
Truvada QD + raltegravir [Isentress] BID or Tivicay [dolutegravir] QD
Truvada QD + darunavir [Prezista] QD and ritonavir [Norvir] QD
PrEP regimen
Descovy
Truvada
Paxlovid
nirmatrelvir/ritonavir
Veklury
remsdesivir
Lagevrio
molnupiravir
antidepressants line of therapy
1st line: SSRI
2nd line: SNRI
3rd line: TCAs, MAOI
Lexapro
escitalopram
SSRI
Zoloft
sertraline
SSRI
Paxil
paroxetine
SSRI
Prozac
fluoxetine
QAM
SSRI
Sarafem
fluoxetine
*for premenstrual dysphoric disorder
Cymbalta
duloxetine DR
SNRI
Drizalma Sprinkle
duloxetine DR
SNRI
Effexor
venlafaxine
SNRI
Trintellix
vortioxetine
SNRI
Pristiq
desvenlafaxine
SNRI
Viibryd
vilazodone
* with food
Wellbutrin
bupropion
Zyban
bupropion → for smoking cessation
Remeron
mirtazapine
Norpramin
desipramine
secondary TCA
Pamelor
nortripyline
secondary TCA
Asendin
amoxapine
secondary TCA
Elavil
amitriptyline
tertiary TCA
Tofranil
imipramine
tertiary TCA
Sinequan
doxepin
tertiary TCA
Silenor
doxepin for insomnia
tertiary TCA
Anafranil
clomipramine; also for OCD
tertiary TCA
Marplan
isocarboxazid
MAOI
Nardil
phenelzine
MAOI
Parnate
tranylcypromine
MAOI
Eldepryl
selegiline patch for PD
MAOI
Emsam
selegiline patch
MAOI
SJW
MAOI
Serzone
nefazodone
Desyrel
trazodone
Vistaril
hydroxyzine
sedating AH
anxiety trx
1st line: SSRI, SNRI, TCA
alt: hydroxyzine, pregabalin, quetiapine, propranolol
LOT BZDs
*safer in elderly
lorazepam, oxazepam, temazepam
Seroquel
quetiappine
Buspar
buspirone
5-HT partial agonist
Ambien
zolpidem
C-IV
BZD receptor agonist
Roszerem
ramelteon
melatonin receptor agonist
Sonata
Zaleplon
C-IV
BZD receptor agonist
Eszopicloneunesta
eszopiclone
C-IV
BZD receptor agonist
Benadryl
diphenhydramine
AH
Belsomra
suvorexant
orexin-receptor antagonist
Thorazine
chlorpromazine
low potency
1st gen AP
Mellaril
thioridazine
low potency
1st gen AP
Trilafon
perphenazine
med potency
1st gen AP
Unisom
doxylamine
AH
Loxitane
loxapine
med potency
1st gen AP
Moban
molindone
med potency
1st gen AP
Stelazine
trifluoperazine
high potency
1st gen AP
Prolixin
fluphenazine
high potency
1st gen AP
2nd gen AP clinical pearls
- atypical
- SE: sedation and metabolic side effects [weight gain, increased BG & TG\
- clozapine BBW: agranulocytosis
- clozapine is most effective but reserve for resistant cases; serum >350 ng/mL
- ziprasidone has risk of QT prolongation
1st gen AP clinical pearls
- typical
- SE: EPS, orthostasis, QT prolongation, anticholingeric, skin rxn
- DA agonist
Haldol
haloperidol
high potency
1st gen AP
FazaClo ODT
clozapine
2nd gen AP
Navane
thiothixene
high potency
1st gen AP
Zyprexa
olanzapine
2nd gen AP
Clozaril
clozapine
2nd gen AP
Compazine
prochlorperazine
*mainly used as antiemetic
high potency
1st gen AP
Abilify
aripiprazole
2nd gen AP
Geodon
ziprasidone
*tk with food
2nd gen AP
Seroquel
quetiapine
Zydis ODT
olanzapine
2nd gen AP
Risperdal
risperidone
2nd gen AP
Saphris
asenapine
* SL only
2nd gen AP
Lybalvi
olanzapine/samidorphan
2nd gen AP
which 2nd gen APs are weight neutral
aripiprazole & ziprasidone
short-acting 1st gen AP inj
- haloperidol lactate
- fluphenazine
- chlorpromazine
long-acting 1st gen AP
- fluphenazine decanoate
- haloperidol decanoate
short-acting 2nd gen AP inj
- olanzapine
- ziprasidone
Aristada
aripiprazole q6wk
Perseris
risperidone Q1month
long-acting 2nd gen AP inj
- aripiprazole → Maintena [4wk], Aristada [6wk]
- olanzapine → Relprevv [2-4wk]; REMS
- risperidone → Risperdal Consta [2wk], Perseris [1month]
- paliperidone → Sustenna [4wk], Trinza [3 month]
- iloperidone
Relprevv
olanzapine Q2-4wk
Maintena
aripipraole Q4wk
Risperdal Consta
risperidone Q2wk
Sustenna
paliperidone Q4wk
Trinza
paliperidone Q3months
Cogentin
benztropine
anticholinergic
for tremors in PD
PD drugs
- anticholinergics
- amantadine
- MAO-B inhibitors
- dopaminergic agents
- COMT-i [must use with levodopa]
- DA agonists [1st choice]
Artane
trihexyphenidyl
anticholinergic
for initial trx of tremors
Eldepryl
selegiline
*irreversible
MAO-B inhibitor
Osmolex ER
amantadine ER
decreases DA reuptake
for initial trx of tremors & dyskinesias in advanced disease
Xadago
safinamide
*reversible
MAO-B inhibitors
can use in renal impairment
Symmetrel
amantadine
decreases DA reuptake
for initial trx of tremors & dyskinesias in advanced disease
Azilect
rasagiline
*irreversible
MAO-B inhibitor
Duopa
carbidopa/levodopa enteral susp
Rytary
carbidopa/levodopa ER cap
Sinemet
carbidopa/levodopa SR tab
Ongentys
opicapone
COMT inhibitor
for off episodes
Inbrija
inhaled levodopa
Stalevo
carbidopa/levodopa + entacapone
Tasmar
tolcapone
COMT inhibitor
Comtan
entacapone
COMT inhibitor
Cycloset
bromocriptine
*adjunct therapy in diabetes
DA agonist
Mirapex
pramipexole
DA agonist
Kynmobi SL
apomorphine SL
Requip
ropinirole
DA agonist
Apokyn SC
apomorphine SC
* for advanced disease
DA agonist
Aricept
donepezil
acetylcholinesterase inhibitor
Exelon
rivastigmine patch
*tk w/food
acetylcholinesterase inhibitor
Razadyne
galantamine
acetylcholinesterase inhibitor
Neupro
rotigotine patch
DA agonist
Alzheimer’s trx
- acetylcholinesterase inhibitors
- NMDA agonists
Namenda
memantine
NMDA receptor antagonist
Namzaric
mementine ER + donepezil
NMDA receptor antagonist + acetylcholinesterase inhibitor
Aduhelm
aducanumab
monthly IV infusion
1st line for atypical absence myoclonic, atonic
- valproate
- lamotrigine
- levetiracetam
1st line for absence seizures
- valproate
- ethosuximide
Dilantin
phenytoin
1st line for partial seizures
- carbamazepine
- oxcarbazepine
- lamotrigine
- levetiracetam
1st line for generalized tonic-clonic
- valproate
- lamotrigine
- levetiracetam
Tegretol
carbamazepine
Cerebyx
fosphenytoin
Trileptal
oxcarbazepine
Carbatrol
carbamazepine
Topamax
topiramate
Epitol
carbamazepine
Stavzor
valproate
Depakene
valproate
Depakote
divalproex
Lamictal
lamotrigine
Zarontin
ethosuximide
Klonopin
clonazepam
Keppra
levetiracetam
Gabitril
tiagabine
Vimpat
lacosamide
C-V
Neurontin
gabapentin
phenytoin clinical pearls
- mix in ND only
- max 50mg/min
- IV:PO = 1:1
- BBW: teratogenic, skin rash
- supplement w/ folic acid, calcium & vit D
Sabril
Vigabatrin
fosphenytoin clinical pearls
- prodrug of phenytoin
- IV:PO= 1:1
- NS/D5W ok
- BBW: teratogenic, skin rash
Lyrica
pregabalin
C-V
Barbital
phenobarbital
carbamazepine clinical pearls
- therapeutic range: 4-12 mcg/mL
- BBW: serious skin rxn, aplastic anemia & agranulocytosis
valproate clinical pearls
- therapeutic range: 50-100mcg/mL
- BBW: hepatotoxicity, fatal pancreatitis
- SE: weight gain
topiramate clinical pearls
- CI if sulfa allergy
- teratogenic
- causes weight loss
- oligohydrosis
zonisamide clinical pearls
- CI if sulfa allergy
- weight loss
bipolar depression trx
- quetiapine
- quetiapine/fluoxetine
- lurasidone
levetiracetam clinical pearls
- weight loss
*no significant drug interactions
Xcopri
cenobamate
for partial onset seizures
ethosuximide clinical pearls
blood dyscrasias
lamotrigine clinical pearls
- max 400mg/day
- BBW: skin rash, aseptic meningitis
felbamate clinical pearls
- BBW: hepatotoxicity, aplastic anemia
bipolar disorder trx
- lithium
- anticonvulsants
- antipsychotics [off-label]
which AP is the only one FDA-approved for bipolar disorder
quetiapine
therapeutic range for lithium
0.6-1.2 mEq/L
*can still be toxic at therapeutic dose
relationship between lithium & salt
decreased salt intake, dehydration = increased lithium
increased salt intake, caffeine = decreased lithium
Ritalin
methylphenidate
therapeutic range of lamotrigine
1-4 ug/mL
therapeutic range of valproate
50-125 ug/mL
Methylin
methylphenidate
Methyl ER
methylphenidate
therapeutic range of carbamazepine
4-12 ug/mL
ADHD trx
- stimulants
- atomoxetine
- adjunctive trx
lithium clinical pearls
- can be toxic at therapeutic dose
- ADE: cognitive effects, hand tremor, weight gain, polyuria, polydipsia, hypothyroidism, sedation
- DDIs w/ NSAIDs, diuretics, ACE-I/ARB, SSRIs, SNRIs
- monitor: BMP, renal, thyroid
- drink water & take with meals
Aptensio XR
methylphenidate
Daytrana
methylphenidate patch
Adhansia XR
methylphenidate
Jornay PM
methylphenidate
Concerta OROS
methylphenidate = TID dosing
Azstarys
serdexmethylphenidate/dexmethylphenidate
Vyvanse
lisdexamphetamine
Focalin
dexmethylphenidate
Cotempla XR
methylphenidate ODT
Dextrostat
dextroamphetamine
Dexedrine
dextroamphetamine
Adderall
amphetamine mixed salts
Strattera
atomoxetine
SNRI
- no abuse potential
Intuniv
guanfacine ER
alpha2 adrenergic agonist
Kapvay
clonidine ER
alpha2 adrenergic agonist
Provigil
modafinil
C-IV
stimulant for narcolepsy
Sunosi
solriamfetol
C-IV
stimulants for narcolepsy
Qelbree
viloxazine
for ADHD
Nuvigil
armodafinil
C-IV
stimulant for narcolepsy
gout ppx
- lifestyle modifications
- anti-inflammatory → colchicine 0.6mg or naproxen 250mg BID, prednisolone/prednisone
Uloric
febuxostat
decrease UA production
gout acute attack trx
- NSAIDs: indomethacin
- colchicine
- steroids: prednisone, methylprednisolone, triamcinolone
Benemid
probenecid
increase UA excretion
Aloprim
allopurinol IV
decrease UA production
gout management trx
decrease UA production:
- allopurinol w/ meal
- febuxostat
increase UA excretion
- probenecid [Benemid]
- other agents: losartan, fenofibrate
AlternaGel
aluminum hydroxide
aluminum-based phosphate binder
Zyloprim
allopurinol PO
decrease UA production
Phoslyra
calcium acetate
calcium based phosphate binder
Amphojel
aluminum hydroxide
aluminum based phosphate binder
PhosLo
calcium acetate
calcium based phosphate binder
TUMS
calcium carbonate
calcium based phosphate binder
Fosrenol
lanthanum carbonate
Al/Ca-free phosphate binder
Renvela
sevelamer
Al/Ca-free phosphate binder
Drisdol
ergocalciferol
Vit D2
inactive vit D
Antivert
meclizine
AH
Compazine
prochlorperazine
Rocatrol
calcitriol
Vit D3
active vit D
Renagel
sevelamer
Al/Ca-free phosphate binder
N/V trx for pregnancy
1st line:
- vit B6 [pyridoxine]
- AH: doxylamine [Unisom], diphenhydramine, meclizine [Antivert, Dramamine]
2nd line:
- DA antagonist: promethazine [Phenergan], prochlorperazine [Compazine], metoclopramide [Reglan]
3rd line:
- 5HT antagonist: ondansetron [Zofran]
- corticosteroids [avoid 1st trimester]: methylprednisolone, dexamethasone, prednisolone
Unisom
doxylamine
AH
Phenergan
promethazine
Dramamine
meclizine
AH
Reglan
metoclopramide
motion sickness trx
scopolamine 3-day patch
Zofran
ondansetron
Transderm Scop
scopolamine 3-day patch
nicotine lozenge dosing
4mg if smoke 30 min of awakening
2mg if smoking 30 min or later of awakening
- use at least 9 pieces/day for first 6 weeks
- 3 month regimen
nicotine gum dosing
2mg if <25 cigs/day
4mg if >25 cigs/day
- at least 9 pieces/day for first 6 weeks
- 3 month regimen
nicotine nasal spray dosing
1-2 doses per hour for 3 months
1 dose = 2 sprays = 1 spray in each nostril = 1mg nicotine
- max 5 doses/hr or 40 doses/day
nicotine patch dosing
- 21mg/day
- 14mg/day
- 7mg/day
- duration 8-10 weeks
- wear for 16 hours
nicotine inhaler dosing
continuous puffing for 20 min
max 16 cartridges/day
bupropion dosing for smoking cessation
SR 150mg QD x3 days → 150mg BID x7-12 weeks
- stop smoking after 1-2 weeks of treatment
oral agents for smoking cessation
- bupropion SR [Zyban 150 SR}
- varenicline [Chantix]
varenicline dosing for smoking cessation
0.5mg QD → 0.5mg BID → 1mg BID
- start 1 week before quit day
Chantix
varenicline
Zomig
zolmitriptan
5HT1 agonist
Reyvow
lasmiditan
serotonin 1F agonist for acute trx of migraine
Fioricet
APAP + butalbital + caffeine
for migraines
Maxalt
rizatriptan
5HT1 agonist
Fiorinal
ASA + butalbital + caffeine
C-III
for migraine trx
Migranal
dihydroergotamine
ergot alkaloids
preg cat X
Relpax
eletriptan
5HT1 agonist
Imitrex
sumatriptan
5HT1 agonist
migraine ppx
- topiramate
- propranolol
- timolol
- amitriptyline
- divalproex
Nurtec ODT
remegepant
calcitonin gene-related peptide receptor antagonist for acute trx of migraine
FROVA
frovatriptan succinate
for acute trx of migraines
Ajovy
fremanezumab
for migraine ppx
Aimovig
erenumab
for migraine ppx
estrogen CI
- breast cancer
- DVT/PE/stroke/MI
- liver dysfunction
- pregnancy
Qulipta
atogepant
calcitonin gene-related peptide receptor antagonist for migraine prevention
Emgality
galcanezumab
for migraine ppx
Vyepti
eptinezumab
for migraine ppx
progestin HRT
- medroxyprogesterone [Provera PO & Depo-Provera IM/SC]
- HRT/amenorrhea/endometriosis: lower dose
- contraception: 150mg IM or 104mg SC Q3months
- POP/mini-pill for birth control
- MIRENA: IUD
estrogen HRT
only for women w/ no uterus
tab: Estrace, Premarin, Cenestin
patch: Alora, Climara, Estraderm/Vivelle Dot
vag ring: Estring, Femring
top: Estrasorb
testosterone formulations
oral: Androxy, Android, Methitest, Testred, Jatenzo
IM: Depo-Testosterone, Delatestryl, Xyosted, Aveed
top gel: AndroGel 1%, AndroGel 1.62%, Fortesta 2%, Testim 1%
top sol: Axiron 2%
nasal gel: Natesto
buccal tabs: Striant
SC pellets: Testopel
transdermal: Androderm 24H
Delatestryl
testosterone enanthate IM
Xyosted
testosterone enanthate SC
monophasic COC
YASMIN
Apri
Femcon Fe
Loestrin
Low-Ogestrel
Desogen
Demulen
Ortho-Cyclen
Ovcon
Ortho-Novum
Necon
estrogen + progestin HRT
women with a uterus
tab: Activella, Femhrt, Estratest [w/ testosterone] and Premphase or Prempro [w/ medroxyprogesterone]
patch: Climara Pro, CombiPatch
Aveed
long-acting undecanoate
REMS
Depo-Testosterone
testosterone cypionate
four-phasic COC
NATAZIA
for heavy menstrual bleeding
which COCs have drospirenone
Yasmin, Nextstellis, Yaz, Beyaz
bi-phasic COC
Kariva
Mircette Ortho-Novum 10/11
tri-phasic
Ortho Tri-Cyclen
Cyclessa
EstroStep
Triphasil
Tri-Norinyl
Ortho-Novum 7/7/7
extended-cycle COC
- 24 days: Nextstellis, YAZ, Beyaz
- 3 months: Seasonale & Seasonique
- 12 months: Amethyst
Nextstellis
drospirenone/estetrol
combined hormonal patches
Xulane
Twirla
combined hormonal vaginal ring
NuvaRIng Qmonth
Annovera reuse up to 1 year
norethindrone POPs
Ortho Micronor
Camila
Errin
Jencycla
Nor-QD
drospirenone POP
Slynd
progestin only IUD
levonorgestrel → Mirena, Skyla
Plan B Next Choice
two 0.75mg tabs of levonorgestrel Q12H
Ella
ulipristal
progestin only implant
etonogestrel
which drugs do you need back up contraception for
- rifampin
- ABXs
- AEDs
- SJW
- antiretrovirals
Plan B One-Step
one 1.5mg tab of levonorgestrel
progestin only shot
medroxyprogesterone acetate
hypothyroidism description
- low T4
- Hashimoto’s, Cretinism, Myxedema
- fatigue, weight gain, cold intolerance, hoarseness, dry skin, constipation, puffy face, muscle weakness
- due to lithium, amiodarone, interferons
hyperthyroidism descriptoin
- high T4
- Graves’, Plummer’s , thyrotoxicosis
- heat intolerance, exopthalmos, sweating, weight loss, irritability, insomnia, tachycardia
- due to iodide, amiodarone, interferons
levothyroxine IV:PO
IV:PO = 0.75:1
Cytomel, Triostate
liothyronine; T3
thyroid supplement
Tapazole
methimazole
DOC
thionamide
levothyroxine colors
Orangutans Will Vomit On You Right Before They Become Large, Proud Giants
25 mcg - orange
50 mcg - white [no dye]
75 mcg - violet
88 mcg - olive
100 mcg - yellow
112 mcg - rose
125 mcg - brown
137 mcg - turquoise
150 mcg - blue
175 mcg - lilac
200 mcg - pink
300 mcg - green
Armour Thyroid
thyroid desiccated; T4 + T3
thyroid supplement
Thyrolar
Liotrix; T4 + T3
thyroid supplement
Levothroid, Levoxyl, Synthroid, Unithroid
levothyroxine; T4
thyroid supplement
PTU
propylthiouracil
thionamide
hyperthyroid in pregnancy
1st trimester: PTU
2nd & 3rd: methimazole
Zonegran
zonisamide
Luminal
phenobarbital
Mysoline
primidone
SSKI, Lugol’s solution
iodide
for thyroid storm
Citracal
calcium citrate
osteoporosis trx
- bisphosphonates
- denosumab
- raloxifene
- estrogen-progestin replacement therapy
- calcitonin
- teriparatide
Boniva
ibandronate Q3 mo
bisphosphonate
PO or IV
Reclast
zoledronic acid Qyear
bisphosphonate
Actonel
risendronate
bisphosphonate
Atelvia
risedronate DR
bisphosphonate
Fosamax
alendronate
bisphosphonate
Prolia
denosumab
for osteoporosis
Xgeva
denosumab
for malignancy
Evista
raloxifene
estrogen rec. modulator
Miacalcin
calcitonin inj
Fortical
calcitonin nasal
Forteo
teriparatide
parathyroid hormone analog
Taxotene
docetaxel
taxane
M phase
antimicrotubule
Taxol, Onxol, Paxene
paclitaxel
taxane
M phase
antimicrotubule
Navelbine
vinorelbine
vinca alkaloid
M phase specific
antimicrotubule
Velban, Velbe
vinblastine
vinca alkaloid
M phase specific
antimicrotubule
Vincasar, Oncovin, Vincrex
vincristine
vinca alkaloid
M phase specific
antimicrotubule
chemo antimicrotubule agents
epothilones
halicondrin B analogues
taxanes
vinca alkaloids
M topo II inhibitors
anthracemedione
anthracyclines
epipodophyllotoxins
Cerubidine
daunorubicin
anthracycline
M topo II inhibitor
Adriamycin, Doxil, Rubex, Caelyx, Myocet
doxorubicin
anthracycline
M topo II inhibitor
Ellence
epirubicin
anthracycline
M topo II inhibitor
Idamycin
idarubicin
anthracycline
tM opo II inhibitor
Novantrone
mitoxantrone
anthracycline
M topo II inhibitor
Zinecard
dexrazoxane
prevents heart damage from anthracyclines
Totect
dexrazoxane
treats extravasation
Paraplatin
carboplatin
platinum-based compound
Platinol
cisplatin
platinum-based compound
Eloxatin
oxaliplatin
platinum-based compound
S topo II inhibitors
anthracemedione
anthracyclines
Camptosar
irinotecan
S topo II inhibitor
S phase specific
VePesid, Etopophos, Toposar
etoposide
S topo II inhibitor
S phase specific
Hycamtin
topotecan
S topo II inhibitor
S phase specific
antimetabolites
folate antagonists
purine analogues
pyrimidine analogues
hydroxyurea
Imuran
azathioprine
purine analog metabolite
S phase specific
Fludara
fludarabine
purine analog metabolite
S phase specific
Purinethol
6-mercaptopurine
purine analog metabolite
S phase specific
Lanvis, Tabloid
6-thioguanine
purine analog metabolite
S phase specific
Alimta
pemetrexed
folate metabolite
S phase specificolate
Rheumatrex, Trexall, Mexate
methotrexate
folate metabolite
S phase specificolate
methotrexate antidotes
leucovorin [folic acid]
Xeloda
capecitabine [5-FU prodrug]
pyrimidine analog
s phase specific
Adrucil, Carac, Efudex
5-FU
pyrimidine analog
s phase specific
Cytosar-U
cytarabine
pyrimidine analog
s phase specific
Gemzar
gemcitabine
pyrimidine analog
s phase specific
Treanda
bendamustine
alkylator
Busulfex inj, Myleran
busulfan
alkylator
Thioplex
thiotepa
alkylator
BiCNU, Gliadel
carmustine
alkylator
Leukeran
chlorambucil
alkylator
Cytoxan, Neosar, Procytox
cyclophosphamide
alkylator
Ifex
ifosfamide
alkylator
CeeNU
lomustine
alkylator
Zytiga
abiraterone
prostate cancer
Casodex
bicalutamide
prostate cancer
Zoladex
goserelin
prostate cancer
Eulexin
flutamide
prostate cancer
Lupron
leuprolide
prostate cancer
Gleevec, Glivec
imatinib
TKI
Tarceva
erlotinib
TKI
Afinitor
everolimus
TKI
Sprycel
dasatinib
TKI
Tasigna
nilotinib
TKI
Sutent
sunitinib
TKI
Nexavar
sorafenib
TKI
Iressa
gefitinib
TKI
Tykerb
lapatinib
TKI
Aliqopa
copanlisib
TKI
Alunbrig
brigatinib
TKI
Calquenbce
acalabrutinib
TKI
Kisqali
ribociclib
TKI
Nerlynx
neratinib
TKI
Rydapt
midostaurin
TKI
Verzenio
abemaciclib
TKI
Revimid
lenalidomide
immunomodulator
Proleukin
aldesleukin, IL-2
immunomodulator
Aldara
imiquimod
immunomodulator
Thalomid
thalidomide
immunomodulator
REMS
Rituxan
rituximab
mAb
Avastin
bevacizumab
mAb
Herceptin
trastuzumab
mAb
Erbitux
cetuximab
mAb
Yervoy
ipilimumab
mAb
Campath
alemtuzumab
mAb
Mylotarg
gemtuzumab
mAb
Zevalin
irbritumomab
mAb
Bexxar
tositumomab
mAb
Velcade
bortezomib
Elspar
asparaginase
Blenoxane
bleomycin
Cosmegen
dactinomycin
Targretin
bexarotene
Alkeran
melphalan
Emcyt
estramustine
Hydrea
hydroxyurea
Mutamycin
mitomycin
Mustargen
mechlorethamine
Zanosar
streptozocin
Idhifa
enasidenib
Zejula
niraparib
Arimidex
anazstrole
oral aromatase inhibitors [after menopause] for breast cancer
Aromasin
exemestane
oral aromatase inhibitors [after menopause] for breast cancer
Femara
letrozole
oral aromatase inhibitors [after menopause] for breast cancer
Faslodex
fulvestrant
oral aromatase inhibitors [after menopause] for breast cancer
Fareston
toremifene
oral estrogen blocker for breast cancer
Nolvadex
tamoxifen
oral estrogen blocker for breast cancer
Megace
megestrol
for breast & uterine cancer
Metamucil
psyllium
fiber/bulk forming laxative
Citrucel
methylcellulose
fiber/bulk forming laxative
FiberCon
polycarbophil
fiber/bulk forming laxative
Colace
docusate sodium
stool softener [emolient]
Kaopectate Liqui-Gel
docusate calcium
stol softener [emollient]
Nujol
mineral oil
lubricant
Dulcolax
bisacodyl
stimulant
Senokot, Ex-lax
senna
stimulant
Citroma
magnesium citrate
saline cathartic
osmotic laxative
Epsom salt
magnesium sulfate
saline cathartic
osmotic laxative
Milk of Magnesia
magnesium hydroxide
saline cathartic
osmotic laxative
Fleets Phospho-Soda
sodium phosphate
saline cathartic
osmotic laxative
Duphalac, Chronulac
lactulose
hyperosmotic
osmotic laxative
Miralax, Carbowax, Golytely
polyethylene glycol
hyperosmotic
osmotic laxative
Relistor
methylnaltrexone
gut opioid blocker
only for pts on opioids & failed docusate + senna or bisacodyl
Trulance
plecanatide
chronic idiopathic constipation
Linzess
linaclotide
chronic idiopathic constipation
Amitiza
lubiprostone
chronic idiopathic constipation
Imodium
loperamide
diarrhea
Lomotil
diphenoxylate + atropine
C-V
diarrhea
Pepto-Bismol, Kaopectate
bismuth subsalicylate
Lotronex
alosetron
for women w/ IBD + diarrhea as main symptom
Bentyl
dicyclomine
antispasmodic [anticholinergic]
Azulfidine, Sulfazine
sulfasalazine
aminosalicylate
Asacol, Pentasa, Lialda, Canada supp, Rowasa enema
mesalamine
aminosalicylate for IBD
IBD maintenance
- aminosalicylates
- sulfasalazine
- mesalamine - immunosuppressives
- azathioprine
- 6-mercaptopurine
- methotrexate - mAbs
- infliximab
- adalimumab
- certolizumab
- natalizumab
Remicade
infliximab
Humira, Cyltezo, Abrildad, Hadlima
adalimumab
Cimzia
certolizumab
Tysabri
natalizumab
Avonex
interferon beta-1a
1x weekly
SC immune modulator for MS
Rebif
interferon beta-1a
3x/weekly
SC immune modulator for MS
Betaseron
interferon beta-1b
QOD
SC immune modulator for MS
Extavia
interferon beta-1b QOD
SC immune modulator for MS
Copaxone
glatiramer acetate
SC immune modulator for MS
Plegridy
peginterferon beta-1a
SC immune modulator for MS
Kesimpta
ofatumumab
SC immune modulator for MS
GIlenya
fingolimod
oral immune modulator for MS
Aubagio
teriflunomide
SC immune modulator for MS
Tecfidera
dimethyl fumarate
SC immune modulator for MS
Mayzent
siponimod
SC immune modulator for MS
Vumerity
diroximel fumarate
SC immune modulator for MS
Zeposia
ozsanimod
SC immune modulator for MS
Ponvory
ponesimod
SC immune modulator for MS
Tysabri
natalizumab
mAb for MS
Lemtrada
alentuzumab
mAb for MS
Ocrevus
ocrelizumab
mAb for MS
Rituxan
rituximab
mAb for MS
Ampyra
dalfampridine
to help improve walking in MS
Pepcid
famotidine
H2RA
Axid
nizatidine
H2RA
Tagamet
cimetidine
H2RA
Prilosec
omeprazole
PPI
Zegerid
omeprazole/Na bicarb
PPI
Nexium
esomeprazole
PO or IV
PPI
Prevacid
lansoprazole
PPI
Dexilant
dexlansoprazole
PPI
Aciphex
rabeprazole
Protonix
pantoprazole
PO or IV
PPI
Reglan
metoclopramide
Carafate
sucralfate
cytoprotective agent
Cytotec
misoprostol
cytoprotective agent
Pepto-Bismol
bismuth subsalicylate
cytoprotective agent
antidiarrheal
triple therapy LAC regimen
lansoprazole
amoxicillin BID
clarithromycin BID
x10-14 day
triple therapy BMT
bismuth
metronidazole
tetracycline
x14 days
triple therapy PrevPac
lansoprazole
amoxicllin
clarithromycin BID
x14 days
quadruple therapy Pylera
bismuth
metronidazole
tetracycline QID
PPI BID
x10 days
quadruple therapy Helidac
bismuth
metronidazole
tetracycline QID x14 days
H2RA x28 days
NSAID BBW
COX-2 selective: CV thrombotic events
COX-1 selective: GI bleeding
Bayer, Ascriptin, Bufferin, Ecotrin
aspirin
cardioprotection
Aleve
naproxen OTC
220mg BID
Naprosyn, Naprelan, Anaprox
naproxen Rx
Vimovo
naproxen + esomeprazole
Indocin
indomethacin
for gout
Feldene
piroxicam
most GI toxic
Toradol
ketorolac
most GI toxic
5 days max trx
Ultracet
APAP + tramadol
antidote for APAP
NAC
Motrin, Advil
ibuprofen
Cataflam, Voltaren
diclofenac
Celebrex
celecoxib
COX-2 selective
Arthrotec
diclofenac + misoprostol
Mobic
meloxicam
COX-2 selective
Lodine
etodolac
COX-2 selective
Dolobid
diflunisal
COX-2 selective
Ofirmev
IV APAP
Caldolor
IV ibuprofen
Clinoril
sulindac
Daypro
oxaprozin
Disalcid
salsalate
Orudis
ketoprofen
Embeda
morphine + naltrexone
Vantrela ER
hydrocodone abuse deterrent
Narcan
naloxone
Suboxone
buprenorphine + naloxone
Subutex
buprenorphine SL
Cassipa
buprenorphine + naloxone higher strength
Sublocade
buprenorphine SC Qmon
Buprenex, Butrans, Probuphine, Belbuca
buprenorphine implant
Stadol
butorphanol
C-IV
opioid agonist
Nubain
nalbuphine
opioid agonist
Talwin
pentazocine
C-IV
opioid agonist
Robaxin
methocarbamol
muscle relaxant
Zanaflex
tizanidine
muscle relaxant
Lucemyra
lofexidine
opioid agonist
Soma
carisoprodol
C-IV
muscle relaxant
Savella
milnacipran
for fibromyalgia
Proventil HFA
albuterol MDI
SABA
Lioresal
baclofen
muscle relaxant
Flexeril
cyclobenzaprine
muscle relaxant
Skelaxin
metaxalone
muscle relaxant
ProAri HFA
albuterol MDI
SABA
Volmax
albuterol sol
SABA
Maxair Autohaler
pirbuterol MDI
SABA
Alvesco
Ciclesonide
ICS
QVAR
beclomethasone
ICS
AccuNeb
albuterol nebulized
SABA
Xopenex HFA
levalbuterol MDI
SABA
Azmacort
triamcinolone
ICS
Flovent
fluticasone
ICS
Asmanex
mometasone
ICS
Ventolin HFA
albuterol MDI
SABA
Proventil
albuterol tabs
SABA
asthma initial therapy
- ICS +/- LTRA
- ICS/LABA
- ICS/LABA + LAMA
advanced therapy: anti-IgE or anti-IL-5
Aerospan, Aerobid
Flunisolide
ICS
Advair
fluticasone + salmeterol
ICS + LABA
24 hour acting LAMAs
tiotropium
glycopyrronium
umeclidinium
Dulera
mometasone + formoterol
ICS + LABA
Serevent Diskus
salmeterol
12 hour
LABA
Symbicort
budesonide + formoterol
ICS + LABA
12 hour acting LAMAs
aclidinium
darotropium
Foradil Aerolizer
formoterol
12 hour
LABA
Accolate
zafirlukast
LTRA
Intal
cromolyn sodium
mast cell stabilizer
Singulair
montelukast
LTRA
Zyflo CR
zileuton
LTRA
Pulmicort
budesonide
ICS
24 hour duration LABAs
indacaterol
vilanterol
olodaterol
abediterol
carmoterol
Elixophyllin, Theo-24, TheoCap, Uniphyl, Theochron
theophylline
bronchodilator
Xolair
omalizumab
anti-IgE
Fasenra
benralizumab
anti IL-5 for eosinophilic disease
Nucala
mepolizumab
anti IL-5
Cinqair
reslizumab
anti IL-5
Flonase, Veramyst
fluticasone nasal
MDI instructions
- prime
- shake well [except QVAR & Alvesco]
- use spacer or rinse mouth
- slowly breath out, hold & breathe normally
- clean weekly
DPI instructions
- no priming
- don’t shake
- use mouthpiece [no spacers]
- inhaled dose fast & deep
- don’t inhale into device
- rinse mouth
- don’t clean, keep dry
Rhinocort Aqua
budesonide nasal
Nasarel
flunisolide nasal
Beconase AQ
beclomethasone nasal
Omnaris
ciclesonide nasal
NasalCrom
cromolyn sodium nasal
Nasonex
mometasone nasal
COPD initial therapy
- LAMA or LABA
- LAMA/LABA
- LAMA/LABA + ICS
advanced therapy
- chronic macrolides
- roflumilast
Lonhala
glycopyrrolate inhalation sol
Hytrin
terazosin
alpha-1 blocker
BPH
Avodart
dutasteride
5-alpha reductase inhibitor for BPH
Cardura
doxazosin
alpha-1 blocker
BPH
Flomax
tamsulosin
alpha-1 blocker
BPH
Uroxatral
alfuzosin
alpha-1 blocker
BPH
Daliresp
roflumilast
PDE 4 inhibitor
Proscar
finasteride
5-alpha reductase inhibitor for BPH
Minioress
prazosin
alpha-1 blocker
BPH
Rapaflo
silodosin
alpha-1 blocker
BPH
Propecia
finasteride
for male pattern baldness
Levitra
vardenafil
PDE-5 inhibitor for ED
Revatio
sildenafil
PDE-5 inhibitor for PAH
Viagra
sildenafil
PDE-5 inhibitor for ED
Adcirca
tadalafil
PDE-5 inhibitor for PAH
Caverject
alprostadil inj for ED
Tracleer
bosentan
PAH
Detrol
tolterodine
anticholinergic for urinary incontinence/overactive bladder
Vesicare
solifenacin
anticholinergic for urinary incontinence/overactive bladder
Prostacyclin, Flolan
epoprostenol
PAH
Staxyn ODT
vardenafil ODT
PDE-5 inhibitor for ED
Cialis
tadalafil
PDE-5 inhibitor for ED & BPH
Ventavis
Iloprost
PAH
Ditropan, Oxytrol
oxybutynin
anticholinergic for urinary incontinence/overactive bladder
Enablex
darifenacin
anticholinergic for urinary incontinence/overactive bladder
Myrbetriq
mirabegron
anticholinergic for urinary incontinence/overactive bladder
Tavist
clemastine
1st AH
Toviaz
fesoterodine
anticholinergic for urinary incontinence/overactive bladder
Sanctura
trospium
anticholinergic for urinary incontinence/overactive bladder
Chlor-Trimeton
chlorpheniramine
1st AH
Unisom
doxylamine
1st AH
Benadryl
diphenhydramine
1st AH
Zyrtec
cetirizine
2nd gen AH
Phenergan
promethazine
1st AH
Claritin
loratadine
2nd gen AH
Allegra
fexofenadine
2nd gen AH
Xyzal
levocetirizine
2nd gen AH
Clarinex
desloratadine
2nd gen AH
Coricidin HBP
chlorpheniramine + dextromethorphan + guaifenesin + APAP
alpha-adrenergic agonist
Privine
naphazoline
decongestant nasal
Astelin, Astepro
azelastine
2nd gen AH nasal
Patanase
olopatadine
2nd gen AH nasal
Sudafed
pseudoephedrine
decongestant
Otrivin
xylometazoline
decongestant nasal
Neo-Synephrine 4-hour
phenylephrine
decongestant nasal
Delsym
dextromethorphan
antitussive
Sudafed PE
phenylephrine
decongestant
Afrin, Neo-Synephrine 12-Hr
oxymetazoline
decongestant nasal
Travatan 2
travoprost
prostaglandin analog
glaucoma
Mucinex
guaifenesin
expectorant
Xelpros
latanoprost w/o preservative
prostaglandin analog
glaucoma
Lumigan, Durysta Implant
bimatoprost
prostaglandin analog
glaucoma
Betoptic S
betaxolol
beta-blocker
glaucoma
Timoptic
timolol
beta-blocker
glaucoma
Zioptan
tafluprost
prostaglandin analog
glaucoma
Betagan
levobunolol
beta-blocker
glaucoma
Trusopt
dorzolamide
carbonic anhydrase inhibitor
glaucoma
Xalatan
latanoprost w/ preservative
prostaglandin analog
glaucoma
Vyzulta
latanoprostene bunod
prostaglandin analog
glaucoma
Ocupress
carteolol
beta-blocker
glaucoma
Cosopt
dorzolamide/timolol
carbonic anhydrase inhibitor
glaucoma
OptiPranolol
metipranolol
beta-blocker
glaucoma
Azopt
brinzolamide
carbonic anhydrase inhibitor
glaucoma
Diamox
acetazolamide
diuretic
glaucoma
Alphagan 0.1%, 0.15%, 0.2%
brimonidine
alpha-agonist/adrenergic
glaucoma
Combigan
brimonidine/timolol
alpha agonist/adrenergic
Emadine
emedastine
AH
allergic conjunctivitis
Lumify 0.025%
brimonidine
alpha-agonist/adrenergic
OTC low-dose ocular redness
Rhopressa
netarsudil
rho kinase inhibitor
glaucoma
Zaditor, Alaway
ketotifen
AH
allergic conjunctivitis
Naphcon-A, Opcon-A, Visine-A
naphazoline/pheniramine
AH/decongestant
allergic conjunctivitis
Alocril
nedocromil
mast cell stabilizer
allergic conjunctivitis
Acular
ketorolac
NSAID
allergic conjunctivitis
Lotemax
loteprednol
allergic conjunctivitis
Restasis
cyclosporine 0.05% ophth
dry eyes
Optivar
azelastine
AH
allergic conjunctivitis
Azasite
azithromycin
bacterial conjunctivitis
Vigamox
moxifloxacin
bacterial conjunctivitis
Ciloxan
ciprofloxacin
bacterial conjunctivitis
Tobrex
tobramycin
bacterial conjunctivitis
Garamycin
gentamicin
bacterial conjunctivitis
Polytrim
trimethoprim/polymyxin
bacterial conjunctivitis
Neosporin
neomycin/bacitracin/polymyxin
bacterial conjunctivitis
Besivance
besifloxacin
bacterial conjunctivitis
Cequa
cyclosporine 0.09% ophth
dry eyes
Ocuflox
ofloxacin
bacterial conjunctivitis
A/B Otic, Auralgan
antipyrine/benzocaine
otitis media
Americaine Otic
benzocaine
otitis media
Cerumenex
triethanolamine
ear wax removal
Topicort
desocimetasone 0.05-0.25%
high potency top steroid
Floxin Otic
ciprofloxacin
otitis media
Cipro HC
ciprofloxacin/hydrocortisone
otitis media
Debrox
carbamide peroxide
ear way removal
Vanos cream, Lidex
fluocinonide 0.05-0.1%
high potency top steroid
Ciprodex
ciprofloxacin/dexamethasone
otitis media
Ultravate
halobetasol 0.05%
high potency top steroid
Cortisporin
neomycin/hydrocortisone
otitis media
Kenalog
triamcinolone 0.1%
med potency top steroid
Clobex, Cormax, Olux, Temovate
clobetasol 0.05%
high potency top steroid
Psorcon
diflorasone 0.05%
high potency top steroid
Elocon
mometasone 0.1%
med potency top steroid
Benoxyl, Benzac, Clearsil, BenzaClin, Duac
topical benozyl peroxide
acne
DermAtop
prednicarbate 0.1%
med potency top steroid
Differin
adapalene
top retinoid
acne
Tazorac
tazarotene
top retinoid
acne
Hytone
hydrocortisone 0.5-2.5%
low potency top steroid
Retin-A, Avita
tretinoin
top retinoid
acne
Cultivate
fluticasone 0.005%
med potency top steroid
Aczone
dapsone gel
top retinoid
acne
DesOwen
desonide 0.05%
low potency top steroid
Lamisil
terbinafine 1%
Nizoral A-D
ketoconazole
Accutane, Claravis, Absorica, Amnesteem, Sotret
PO isotretinoin
acne
Lotrimin
clotrimazole 1%
Nizoral
ketoconazole cream
Diflucan
fluconazole
Sporanox
itraconazole
onychomycosis
Eucrisa
crisaborole
atopic dermatitis
Elidel
pimecrolimus
atopic dermatitis
Elimite
permethrin 5% Rx
lice
Natroba
spinosad
lice
RID
pyrethrin
lice
Protopic
tacrolimus
atopic dermatitis
Penlac
ciclopirox
NIX
permethrin 1% OTC
lice
Xeglyze
Abametapir
lice
Dupixent
dupilumab
atopic dermatitis
Aldara
imiquimod
genital warts
Abreva
docosanol
HSV1 cold sores
Ivy Block
bentoquatam
poison ivy
Bactroban
mupirocin
Dovonex
calcipotriene
psoriasis
Neosporin
polymyxin + bacitracin + neomycin
Aveeno
colloidal oatmeal
poison ivy
Taclonex
calcipotriene + betamethasone
psoriasis
Polysporin
bacitracin + polymyxin
Caladryl
calamine
poison ivy
Burrows
Zanfel, aluminum sol
poison ivy
Tazorac
tazarotene
psoriasis
Anthranol, Psoriatec
anthralin
psoriasis
Atrovent
ipratropium
LAMA
Spiriva
tiotropium
LAMA
Combivent
ipratropium + albuterol
LAMA + SABA
Breztri Aerosphere
budesonide + glycopyrrolate + formoterol
corticosteroid + anticholinergic + LABA
Stiolto Respimat
tiotropium/olodaterol
LAMA/LABA
Tudorza
aclidinium
LAMA
Duaklir Pressair
aclidinium/formoterol
LAMA/LABA
Brovana
arformoterol
12 hour
LABA for COPD
Arcapta
indacaterol
LABA
Breo Ellipta
fluticasone + vilanterol
ICS + LABA
Anoro Ellpita
umeclidinium + vilanterol
anticholinergic + LABA
Trelegy Ellipta
umeclidinium + fluticasone + vilanterol
LAMA + ICS + LABA
Seebri Neohaler
glycopyrrolate DPI
Neoral, Sandimmune
cyclosporie
psoriasis
Soriatane
acitretin
psoriasis
Xofluza
baloxavir
influenza
Rogaine
minoxidil
influenza vaccines w/o eggs
flublock
FluMist, MedImmune
influenza nasal vaccine
what is calcium chloride incompatible with
- mag sulfate
- propofol
- sodium bicarbonate
which drugs must be protected from light
- ampB → D5W
- linezolid
- NTG
- NE → D5W or NS
- nitroprusside
Tamiflu
oseltamivir x5 day
influenza
Rapivab
peramivir x1
influenza
what is sodium bicarb incompatible with
- amiodarone
- calcium chloride
- dobutamine
- epi/NE
- isoproterenol
Relenza
zanamivir x5 days
oral inh
influenza
which drugs to dilute in NS
- fluconazole
- daptomycin
- flagyl → don’t refrigerate
- amp, unasyn
- ertapenem
- primaxin
- erythromycin
- insulin
short stability drugs
- bactrim → D5W, don’t refrigerate, 4-6 hours
- phenytoin → NS, don’t refrigerate, 2 hours
- levothyroxine → NS, mix on floor
- infliximab → NS, 3 hours
- filgrastim → NS, 6 hours
which drugs to dilute in D5W
- amiodarone
- synercid
- cipro
patches 12 on 12 off
NTG
lidocaine → can cut
twice a week patches
- alora, estraderm, vivelle dot
- oxybutynine
sulfa drugs
- sulfa ABX
- dapsone
- HIV PI: darunavir, fosamprenavir, tipranavir
- HCV PI: simeprevir
generally tolerated: - loop & thiazide diuretics
- SUs
- carbonic anhydrase inhibitors
- HIV & HCV Pis
- celecoxib, diazoxide, ibutilide, probenecid, sotalol, sumatriptan, tipranavir, topiramate, zonisamide
daily patches
selegiline [Emsam]
methylphenidate [Daytrana]
rivastigmine [Exelon]
testosterone [Androderm]
nicotine patch [NicoDerm, Habitrol]
Q72H patches
- fentanyl
- scopolamine
weekly patches
- climara, menostar [HRT]
- clonidine
- buprenorphine
- anticonceptive patch