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Pharmacy Practice IV > Drug Info > Flashcards

Drug Info Flashcards

1
Q

Rosuvastatin (Crestor) Drug interactions

A

Increases WARFARIN serum levels
GEMFIBROZIL increases drug level
ANTACIDS limit drug absorption (don’t take within 2 hours)

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1
Q

Atorvastatin (Lipitor) Pharmacokinetics

A

CYP 3A4

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2
Q

Atorvastatin (Lipitor) Drug interactions

A

May increase DIGOXIN levels
AZOLE antifungals may increase drug levels
Grapefruit juice increases drug levels

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2
Q

Atorvastatin (Lipitor) consultation

A

Grapefruit juice

Can be dosed in morning, but generally dosed in evening

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2
Q

Lovastatin (Mevacor) Pharmacokinetics

A

CYP3A4

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3
Q

Lovastatin (Mevacor) Contraindications

A

Concomitant Sporanox (itraconazole)

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4
Q

Lovastatin (Mevacor) Drug interactions

A

AZOLE antifungals may increase drug levels

Grapefruit juice increases drug levels

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5
Q

Lovastatin (Mevacor) consultation

A

Grapefruit juice

Take with evening meal

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6
Q

Pravastatin (Pravachol) Drug interactions

A

BAS limit absorption

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7
Q

Pravastatin (Pravachol) consultation

A

Give 1 hour before or 4 hours after BAS

Bedtime dosing

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8
Q

Simvastatin (Zocor) Pharmacokinetics

A

CYP3A4

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9
Q

Simvastatin (Zocor) Drug interactions

A

May increase DIGOXIN and WARFARIN levels
CYCLOSPORINE A, AMIODARONE, VERAPAMIL, AZOLE antifungals, PROTEASE INHIBITORS, and NEFAZODONE increase drug levels
Grapefruit juice increases drug levels

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10
Q

Simvastatin (Zocor) Contraindications

A

Concomitant Sporanox (Itraconazole)

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11
Q

Simvastatin (Zocor) consultation

A

Grapefruit juice

Evening dosing

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12
Q

Gemfibrozil (Lopid) Dosage

A

30 minutes prior to a.m., p.m. meal

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13
Q

Gemfibrozil (Lopid) Drug interactions

A

May increase WARFARIN levels

HMG CoA Reductase inhibitors (risk of myopathy)

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14
Q

Gemfibrozil (Lopid) Contraindications/precautions

A

Hepatic or severe renal dysfunction

pre-existing gallbladder disease

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15
Q

Gemfibrozil (Lopid) adverse effects

A

all GI

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16
Q

Gemfibrozil (Lopid) patient consultation

A

Surveillance for myopathy

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17
Q

Fenofibrate (Tricor, Trilipix) Dosage

A

with meals

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18
Q

Fenofibrate (Tricor, Trilipix) Drug interactions

A

WARFARIN

HMG-CoA Reductase inhibitors

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19
Q

Fenofibrate (Tricor, Trilipix) Contraindications/precautions

A

Hepatic or severe renal dysfunction
Persistent LFT elevations
Pre-existing gallbladder disease

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20
Q

Fenofibrate (Tricor, Trilipix) Adverse effects

A

LFT elevations

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21
Q

Fenofibrate (Tricor, Trilipix) Patient consultation

A

Surveillance for myopathy

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22
Q

Fenofibrate (Tricor, Trilipix) formulations

A

Micronized vs. Non-micronized

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23
Q

Lovaza pharmacology

A

many OTC formulations, but this is RX

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24
Q

Lovaza drug interactions

A

Potential to increase bleeding time with WARFARIN

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25
Q

Lovaza precautions

A

Allergy to fish

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26
Q

Lovaza adverse effects

A

Belching, dyspepsia, taste disturbances

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27
Q

Lovaza Patient consultation

A

Take with food

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28
Q

Questran Drug interactions

A

Reduces absorption of many drugs

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29
Q

Questran precautions

A

GI motility problems

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30
Q

Questran adverse effects

A

Constipation, N/V

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31
Q

Questran patient consultation

A

Other meds to be given 1 hour before or 4 hours after
Give w/ample fluids (chilled may taste best)
Counsel on mixing instructions and potential for constipation

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32
Q

Colesevelam (Welchol) precautions

A

GI motility problems

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33
Q

Colesevelam Adverse effects

A

Constipation, dyspepsia

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34
Q

Colesevelam patient consultation

A

Ample fluids

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35
Q

Niaspan (Niacin) Dosage

A

Bedtime with low-fat snack

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36
Q

Niaspan (Niacin) Drug interactions

A

HMG CoA reductase inhibitors (myopathy risk)

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37
Q

Niaspan (Niacin) contraindications/precautions

A

Hepatic dysfunction or LFT elevations; diabetes, gout

Baseline + follow-up LFT monitoring

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38
Q

Niaspan (Niacin) Adverse effects

A

Flushing
Pruritus
Rash
GI

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39
Q

Niaspan (Niacin) Patient consultation

A

HS with snack
May pre-medicate with ASA or NSAID; flushing is transient
Avoid alcohol

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40
Q

Ezetimibe (Zetia) Drug interactions

A

Fibric acids increase Cp

Cholestyramine decreases Cp

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41
Q

Ezetimibe (Zetia) precautions

A

Hepatic dysfunction

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42
Q

Ezetimibe (Zetia) Adverse effects

A

minimal

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43
Q

Ezetimibe (Zetia) Patient consultation

A

Taken w/out regard to meals
Do not take within 2 hrs prior or 4 hrs after a BAS
Myopathy counseling if concomitant HMG CoA reductase inhibitor

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44
Q

Furosemide (Lasix) dosage forms

A

oral tablets/solution, intravenous

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45
Q

Furosemide (Lasix) Pharmacokinetics

A

Oral diuresis onset 30-60 mins, peak 1 hr
Oral bioavailability ~ 50-60%
Twice the oral dose for any IV dose

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46
Q

Bumetanide (Bumex) Dosage forms

A

oral and intravenous

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47
Q

Bumetanide (Bumex) Pharmacokinetics

A

Oral diuresis onset 30-60 mins, peak 1-2 hrs
Bioavailability ~ 80-90%
Generally no adjustment oral to IV

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48
Q

Torsemide (Demadex) dosage forms

A

Oral tablets, intravenous

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49
Q

Hydrochlorothiazide precautions

A

impaired renal function

thiazide agents less effective at lower levels of renal fxn

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50
Q

Indapamide (Lozol) dosage forms

A

tablets

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51
Q

Metolazone (Zaroxolyn) dosage forms

A

tablets

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52
Q

Metolazone (Zaroxolyn) precautions

A

may be used in combination with loop diuretics for enhanced diuresis; close fluid/electrolyte monitoring needed

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53
Q

Spironolactone (Aldactone) drug interactions

A

ACE inhibitors, K-sparing medications, K supplements

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54
Q

Spironolactone (Aldactone) contraindications

A

Anuria/renal insufficiency

Hyperkalemia

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55
Q

Spironolactone (Aldactone) Adverse effects

A

Hyperkalemia

gynecomastia

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56
Q

Eplerenone (Inspra) drug interactions

A

CYP 3A4 metabolism; 3A4 inhibitors increase serum levels

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57
Q

Eplerenone (Inspra) contraindications

A

(many); Serum K >/= 5.5, CrCl <50

Use of K supplements or K-sparing diuretics

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58
Q

Eplerenone (Inspra) Adverse effects

A

dizziness, Hyperkalemia - risk correlated with lower renal function, drug interactions and special populations

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59
Q

Eplerenone (Inspra) patient consultation

A

adverse effects, avoidance of potassium

60
Q

Dyazide dosage forms

A

37.5/25mg capsule

61
Q

Dyazide precautions

A

when using with other K-sparing agents

62
Q

Maxzide dosage forms

A

37.5/25mg tablets and 75/50mg tablets

63
Q

Maxzide precautions

A

when using with other K-sparing agents

64
Q

Potassium chloride adverse effects

A

GI

65
Q

Potassium consultation

A

administration

66
Q

Clopidogrel (Plavix) Pharmacology/PK

A

Irreversible effect on platelets

67
Q

Clopidogrel (Plavix) Drug interactions

A

Phenytoin

68
Q

Clopidogrel (Plavix) Adverse effects

A

HA, dizziness, arthralgia

69
Q

Prasugrel (Effient) Pharmacology/PK

A

Irreversible effect on platelets

70
Q

Prasugrel (Effient) Drug interactions

A

Warfarin (increased bleeding risk)

71
Q

Prasugrel (Effient) Adverse effects

A

HA, dizziness, risk of bleeding

72
Q

Prasugrel (Effient) contraindications

A

After CVA/TIA
not recommended > age 75
Weight < 60kg increases bleeding risk

73
Q

Ticlodipine (Ticlid) Pharmacology/PK

A

Irreversible effect on platelets

74
Q

Ticlodipine (Ticlid) contraindications/precautions

A

Blood dyscrasias - lab monitoring req’d

75
Q

Ticlodipine (Ticlid) adverse effects

A

Neutropenia

Thrombocytopenia

76
Q

Ticlodipine (Ticlid) patient consultation

A

CBC lab monitoring is essential

77
Q

Dipyridamole (Persantine) adverse effects

A

Drowsiness, dizziness, hypotension

78
Q

Dipyridamole (Persantine) patient consultation

A

Adverse effects

79
Q

Pentoxifylline (Trental) Drug interactions

A

increases theophylline levels

80
Q

Pentoxifylline (Trental) adverse effects

A

Drowsiness, GI

81
Q

Pentoxifylline (Trental) patient consultation

A

Take with meals

May see effects in 2-4 weeks; up to 8-12 weeks to show full effect

82
Q

Pletal (Cilostazol) Pharmacology/PK

A

CYP3A4

83
Q

Pletal (Cilostazol) drug interactions

A

Diltiazem, grapefruit, MANY others

84
Q

Pletal (Cilostazol) Contraindications

A

HF of any severity

85
Q

Pletal (Cilostazol) Adverse effects

A

HA, dizziness

86
Q

Pletal (Cilostazol) patient consultation

A

may see effects in 2 weeks; up to 12 weeks for full effect

no grapefruit juice

87
Q

Warfarin (Coumadin) Drug interactions

A

BAMIF; (2C9, 3A4)

88
Q

Warfarin (Coumadin) contraindications

A

Pregnancy X, hemorrhagic tendencies, active peptic ulcer

89
Q

Warfarin (Coumadin) Adverse effects

A

bleeding/bruising

90
Q

Warfarin patient consultation

A

TK UTD, avoid alcohol and ASA unless directed, Do not begin or stop other medications unless directed, inform physicians/dentists of use (pre-surgical)

91
Q

Hytrin patient consultation

A

1st dose at bedtime, orthostatic counseling

92
Q

Cardura/XL pharmacology

A

IR peaks in 2-3 hrs

XL peaks in 8-9 hrs

93
Q

Cardura/XL patient consultation

A

IR: 1st dose at bedtime
XL: take in AM with food
insoluble shell may be seen in stool
orthostatic counseling

94
Q

Minipress patient counseling

A

1st dose at bedtime, orthostatic counseling

95
Q

Apresoline (hydralazine) Precautions

A

Long-term use = drug-induced SLE

96
Q

Apresoline (hydralazine) adverse effects

A

dizziness, edema

97
Q

Apresoline (hydralazine) patient consultation

A

take with food, report general fatigue/body aches

98
Q

Catapres (clonidine) drug interactions

A

BETA BLOCKERS

99
Q

Clonidine consultation

A

Do not abruptly d/c

TTS: apply to hairless, healthy skin on upper arm or torso and rotate application site Q 7 days

100
Q

NIfedipine dosage forms

A

capsules/XL tablets

101
Q

Nifedipine pharmacology

A

Dihydropyridine

102
Q

Nifedipine drug interactions

A

cimetidine/grapefruit juice

103
Q

Nifedipine patient consultation

A

empty stomach, do not crush/cut XL

104
Q

Plendil pharmacology

A

dihydropyridine

105
Q

Plendil Adverse effects

A

Rare gingival hyperplasia

106
Q

Plendil patient consultation

A

good dental hygiene

107
Q

Norvasc pharmacology

A

dihydropyridine

kinetics: long terminal half-life

108
Q

Lotrel pharmacology

A

dihydropyridine + ACE-I

109
Q

Cardizem/SR/CD dosage forms

A

Oral and IV

110
Q

Cardizem/SR/CD pharmacology

A

Non-dihydropyridine

kinetics: hepatic metabolism

111
Q

Cardizem/SR/CD patient consultation

A

empty stomach

112
Q

Dilacor XR pharmacology

A

non-dihydropyridine

kinetics: hepatic metabolism

113
Q

Dilacor XR patient consultation

A

empty stomach

114
Q

Verapamil dosage forms

A

oral and IV dosage forms

115
Q

Verapamil pharmacology

A

Non-dihydropyridine

kinetics: hepatic metabolism

116
Q

Verapamil drug interactions

A

therapeutic/toxic effects of beta blockers and digoxin enhanced

117
Q

Verapamil contraindications

A

Severe LV dysfunction

118
Q

Verapamil adverse effects

A

constipation

119
Q

Verapamil patient consultation

A

empty stomach

do not crush SR

120
Q

CCB-DHP class precautions

A

Reflex tachycardia due to vasodilation

theoretical potential to increase angina (less likely if already on BB)

121
Q

CCB-NonDHP class contraindications

A

sick sinus syndrome
>1st degree AV block
SBP < 90

122
Q

CCB-NonDHP class precautions

A

CHF, due to negative inotropic effect

123
Q

CCB-NonDHP drug interactions

A

Carbamazepine effects enhanced

124
Q

CCB-DHP class adverse effects

A

edema, flushing, HA, dizziness, orthostatic effects

125
Q

CCB-NonDHP class adverse effects

A

Edema, HA, Nausea, dizziness, BRADYCARDIA, constipation

126
Q

CCB patient consultation

A

orthostatic counseling

127
Q

Isosorbide dinitrate/SR contraindications

A

note concomitant use with VIAGRA

precautions: tolerance with long-term use

128
Q

Isosorbide dinitrate/SR adverse effects

A

HA, dizziness, flushing, nausea

129
Q

Isosorbide dinitrate/SR patient consultation

A

nitrate free interval

130
Q

Isosorbide mononitrate (Imdur) dosage forms

A

scored tablets

131
Q

Isosorbide mononitrate patient consultation

A

do not crush; can split scored tabs, but swallow whole

132
Q

Nitrostat dosage forms

A

SL, IV

133
Q

Nitrostat adverse effects

A

reflex tachycardia

134
Q

Nitrostat patient consultation

A

Sit down before using SL tabs
dissolve under tongue
3 single tabs 5 mins apart PRN, if no relief call 911
store in original amber vial

135
Q

Nitro-Dur dosage form

A

Transdermal patch

136
Q

Nitro-Dur patient consultation

A

apply patch qam to chest or back
rotate application site daily to avoid irritation
remove patch after 12 hours

137
Q

Lanoxin drug interactions (multiple)

A

Diuretics, amiodarone, erythromycin

138
Q

Lanoxin adverse effects

A

anorexia, nausea, bradycardia, blurred vision, HA

139
Q

Nitrates class contraindications

A

concomitant use with Viagra-class agents

140
Q

nitrates class precautions

A

tolerance develops with daily/long-term use

initiation during hypotension or volume-depletion

141
Q

nitrates class drug interactions

A 
ethanol (vasodilation)
arterial vasodilators (CCB -additive effects)
142
Q

nitrates class adverse effects

A

HA, dizziness, flushing, nausea

143
Q

nitrates class patient consultation

A

dosing schedule for “nitrate free” interval
HA (can use APAP)
orthostatic hypotension
avoid alcohol

144
Q

Amiodarone pharmacology/PK

A

response may take weeks; mean half-life >50 days

145
Q

Amiodarone drug interactions-multiple (high level surveillance)

A

Digoxin, WARFARIN (serious elevation in INR)

146
Q

Amiodarone contraindications/precautions

A

Sinus node dysfunction

pulmonary, hepatic toxicities

147
Q

Amiodarone adverse effects

A

thyroid, ocular abnormalities, photosensitivity

148
Q

Amiodarone patient consultation

A

lab and other monitoring very important; surveillance for toxicities
the pharmacist must confirm frequent warfarin monitoring will occur

149
Q

Dronedarone contraindications

A

Class IV HF

Class II and III HF if recently admitted for decompensated HF

150
Q

Dronedarone adverse effects

A

N/V, diarrhea

151
Q

dronedarone monitoring

A

LFTs

Pharmacy Practice IV (5 decks)

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