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)
1
Q
Atorvastatin (Lipitor) Pharmacokinetics
A
CYP 3A4
2
Q
Atorvastatin (Lipitor) Drug interactions
A
May increase DIGOXIN levels
AZOLE antifungals may increase drug levels
Grapefruit juice increases drug levels
2
Q
Atorvastatin (Lipitor) consultation
A
Grapefruit juice
Can be dosed in morning, but generally dosed in evening
2
Q
Lovastatin (Mevacor) Pharmacokinetics
A
CYP3A4
3
Q
Lovastatin (Mevacor) Contraindications
A
Concomitant Sporanox (itraconazole)
4
Q
Lovastatin (Mevacor) Drug interactions
A
AZOLE antifungals may increase drug levels
Grapefruit juice increases drug levels
5
Q
Lovastatin (Mevacor) consultation
A
Grapefruit juice
Take with evening meal
6
Q
Pravastatin (Pravachol) Drug interactions
A
BAS limit absorption
7
Q
Pravastatin (Pravachol) consultation
A
Give 1 hour before or 4 hours after BAS
Bedtime dosing
8
Q
Simvastatin (Zocor) Pharmacokinetics
A
CYP3A4
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
10
Q
Simvastatin (Zocor) Contraindications
A
Concomitant Sporanox (Itraconazole)
11
Q
Simvastatin (Zocor) consultation
A
Grapefruit juice
Evening dosing
12
Q
Gemfibrozil (Lopid) Dosage
A
30 minutes prior to a.m., p.m. meal
13
Q
Gemfibrozil (Lopid) Drug interactions
A
May increase WARFARIN levels
HMG CoA Reductase inhibitors (risk of myopathy)
14
Q
Gemfibrozil (Lopid) Contraindications/precautions
A
Hepatic or severe renal dysfunction
pre-existing gallbladder disease
15
Q
Gemfibrozil (Lopid) adverse effects
A
all GI
16
Q
Gemfibrozil (Lopid) patient consultation
A
Surveillance for myopathy
17
Q
Fenofibrate (Tricor, Trilipix) Dosage
A
with meals
18
Q
Fenofibrate (Tricor, Trilipix) Drug interactions
A
WARFARIN
HMG-CoA Reductase inhibitors
19
Q
Fenofibrate (Tricor, Trilipix) Contraindications/precautions
A
Hepatic or severe renal dysfunction
Persistent LFT elevations
Pre-existing gallbladder disease
20
Q
Fenofibrate (Tricor, Trilipix) Adverse effects
A
LFT elevations
21
Q
Fenofibrate (Tricor, Trilipix) Patient consultation
A
Surveillance for myopathy
22
Fenofibrate (Tricor, Trilipix) formulations
Micronized vs. Non-micronized
23
Lovaza pharmacology
many OTC formulations, but this is RX
24
Lovaza drug interactions
Potential to increase bleeding time with WARFARIN
25
Lovaza precautions
Allergy to fish
26
Lovaza adverse effects
Belching, dyspepsia, taste disturbances
27
Lovaza Patient consultation
Take with food
28
Questran Drug interactions
Reduces absorption of many drugs
29
Questran precautions
GI motility problems
30
Questran adverse effects
Constipation, N/V
31
Questran patient consultation
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
32
Colesevelam (Welchol) precautions
GI motility problems
33
Colesevelam Adverse effects
Constipation, dyspepsia
34
Colesevelam patient consultation
Ample fluids
35
Niaspan (Niacin) Dosage
Bedtime with low-fat snack
36
Niaspan (Niacin) Drug interactions
HMG CoA reductase inhibitors (myopathy risk)
37
Niaspan (Niacin) contraindications/precautions
Hepatic dysfunction or LFT elevations; diabetes, gout
| Baseline + follow-up LFT monitoring
38
Niaspan (Niacin) Adverse effects
Flushing
Pruritus
Rash
GI
39
Niaspan (Niacin) Patient consultation
HS with snack
May pre-medicate with ASA or NSAID; flushing is transient
Avoid alcohol
40
Ezetimibe (Zetia) Drug interactions
Fibric acids increase Cp
| Cholestyramine decreases Cp
41
Ezetimibe (Zetia) precautions
Hepatic dysfunction
42
Ezetimibe (Zetia) Adverse effects
minimal
43
Ezetimibe (Zetia) Patient consultation
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
44
Furosemide (Lasix) dosage forms
oral tablets/solution, intravenous
45
Furosemide (Lasix) Pharmacokinetics
Oral diuresis onset 30-60 mins, peak 1 hr
Oral bioavailability ~ 50-60%
Twice the oral dose for any IV dose
46
Bumetanide (Bumex) Dosage forms
oral and intravenous
47
Bumetanide (Bumex) Pharmacokinetics
Oral diuresis onset 30-60 mins, peak 1-2 hrs
Bioavailability ~ 80-90%
Generally no adjustment oral to IV
48
Torsemide (Demadex) dosage forms
Oral tablets, intravenous
49
Hydrochlorothiazide precautions
impaired renal function
| thiazide agents less effective at lower levels of renal fxn
50
Indapamide (Lozol) dosage forms
tablets
51
Metolazone (Zaroxolyn) dosage forms
tablets
52
Metolazone (Zaroxolyn) precautions
may be used in combination with loop diuretics for enhanced diuresis; close fluid/electrolyte monitoring needed
53
Spironolactone (Aldactone) drug interactions
ACE inhibitors, K-sparing medications, K supplements
54
Spironolactone (Aldactone) contraindications
Anuria/renal insufficiency
| Hyperkalemia
55
Spironolactone (Aldactone) Adverse effects
Hyperkalemia
| gynecomastia
56
Eplerenone (Inspra) drug interactions
CYP 3A4 metabolism; 3A4 inhibitors increase serum levels
57
Eplerenone (Inspra) contraindications
(many); Serum K >/= 5.5, CrCl <50
| Use of K supplements or K-sparing diuretics
58
Eplerenone (Inspra) Adverse effects
dizziness, Hyperkalemia - risk correlated with lower renal function, drug interactions and special populations
59
Eplerenone (Inspra) patient consultation
adverse effects, avoidance of potassium
60
Dyazide dosage forms
37.5/25mg capsule
61
Dyazide precautions
when using with other K-sparing agents
62
Maxzide dosage forms
37.5/25mg tablets and 75/50mg tablets
63
Maxzide precautions
when using with other K-sparing agents
64
Potassium chloride adverse effects
GI
65
Potassium consultation
administration
66
Clopidogrel (Plavix) Pharmacology/PK
Irreversible effect on platelets
67
Clopidogrel (Plavix) Drug interactions
Phenytoin
68
Clopidogrel (Plavix) Adverse effects
HA, dizziness, arthralgia
69
Prasugrel (Effient) Pharmacology/PK
Irreversible effect on platelets
70
Prasugrel (Effient) Drug interactions
Warfarin (increased bleeding risk)
71
Prasugrel (Effient) Adverse effects
HA, dizziness, risk of bleeding
72
Prasugrel (Effient) contraindications
After CVA/TIA
not recommended > age 75
Weight < 60kg increases bleeding risk
73
Ticlodipine (Ticlid) Pharmacology/PK
Irreversible effect on platelets
74
Ticlodipine (Ticlid) contraindications/precautions
Blood dyscrasias - lab monitoring req'd
75
Ticlodipine (Ticlid) adverse effects
Neutropenia
| Thrombocytopenia
76
Ticlodipine (Ticlid) patient consultation
CBC lab monitoring is essential
77
Dipyridamole (Persantine) adverse effects
Drowsiness, dizziness, hypotension
78
Dipyridamole (Persantine) patient consultation
Adverse effects
79
Pentoxifylline (Trental) Drug interactions
increases theophylline levels
80
Pentoxifylline (Trental) adverse effects
Drowsiness, GI
81
Pentoxifylline (Trental) patient consultation
Take with meals
| May see effects in 2-4 weeks; up to 8-12 weeks to show full effect
82
Pletal (Cilostazol) Pharmacology/PK
CYP3A4
83
Pletal (Cilostazol) drug interactions
Diltiazem, grapefruit, MANY others
84
Pletal (Cilostazol) Contraindications
HF of any severity
85
Pletal (Cilostazol) Adverse effects
HA, dizziness
86
Pletal (Cilostazol) patient consultation
may see effects in 2 weeks; up to 12 weeks for full effect
| no grapefruit juice
87
Warfarin (Coumadin) Drug interactions
BAMIF; (2C9, 3A4)
88
Warfarin (Coumadin) contraindications
Pregnancy X, hemorrhagic tendencies, active peptic ulcer
89
Warfarin (Coumadin) Adverse effects
bleeding/bruising
90
Warfarin patient consultation
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
Hytrin patient consultation
1st dose at bedtime, orthostatic counseling
92
Cardura/XL pharmacology
IR peaks in 2-3 hrs
| XL peaks in 8-9 hrs
93
Cardura/XL patient consultation
IR: 1st dose at bedtime
XL: take in AM with food
insoluble shell may be seen in stool
orthostatic counseling
94
Minipress patient counseling
1st dose at bedtime, orthostatic counseling
95
Apresoline (hydralazine) Precautions
Long-term use = drug-induced SLE
96
Apresoline (hydralazine) adverse effects
dizziness, edema
97
Apresoline (hydralazine) patient consultation
take with food, report general fatigue/body aches
98
Catapres (clonidine) drug interactions
BETA BLOCKERS
99
Clonidine consultation
Do not abruptly d/c
| TTS: apply to hairless, healthy skin on upper arm or torso and rotate application site Q 7 days
100
NIfedipine dosage forms
capsules/XL tablets
101
Nifedipine pharmacology
Dihydropyridine
102
Nifedipine drug interactions
cimetidine/grapefruit juice
103
Nifedipine patient consultation
empty stomach, do not crush/cut XL
104
Plendil pharmacology
dihydropyridine
105
Plendil Adverse effects
Rare gingival hyperplasia
106
Plendil patient consultation
good dental hygiene
107
Norvasc pharmacology
dihydropyridine
| kinetics: long terminal half-life
108
Lotrel pharmacology
dihydropyridine + ACE-I
109
Cardizem/SR/CD dosage forms
Oral and IV
110
Cardizem/SR/CD pharmacology
Non-dihydropyridine
| kinetics: hepatic metabolism
111
Cardizem/SR/CD patient consultation
empty stomach
112
Dilacor XR pharmacology
non-dihydropyridine
| kinetics: hepatic metabolism
113
Dilacor XR patient consultation
empty stomach
114
Verapamil dosage forms
oral and IV dosage forms
115
Verapamil pharmacology
Non-dihydropyridine
| kinetics: hepatic metabolism
116
Verapamil drug interactions
therapeutic/toxic effects of beta blockers and digoxin enhanced
117
Verapamil contraindications
Severe LV dysfunction
118
Verapamil adverse effects
constipation
119
Verapamil patient consultation
empty stomach
| do not crush SR
120
CCB-DHP class precautions
Reflex tachycardia due to vasodilation
| theoretical potential to increase angina (less likely if already on BB)
121
CCB-NonDHP class contraindications
sick sinus syndrome
>1st degree AV block
SBP < 90
122
CCB-NonDHP class precautions
CHF, due to negative inotropic effect
123
CCB-NonDHP drug interactions
Carbamazepine effects enhanced
124
CCB-DHP class adverse effects
edema, flushing, HA, dizziness, orthostatic effects
125
CCB-NonDHP class adverse effects
Edema, HA, Nausea, dizziness, BRADYCARDIA, constipation
126
CCB patient consultation
orthostatic counseling
127
Isosorbide dinitrate/SR contraindications
note concomitant use with VIAGRA
| precautions: tolerance with long-term use
128
Isosorbide dinitrate/SR adverse effects
HA, dizziness, flushing, nausea
129
Isosorbide dinitrate/SR patient consultation
nitrate free interval
130
Isosorbide mononitrate (Imdur) dosage forms
scored tablets
131
Isosorbide mononitrate patient consultation
do not crush; can split scored tabs, but swallow whole
132
Nitrostat dosage forms
SL, IV
133
Nitrostat adverse effects
reflex tachycardia
134
Nitrostat patient consultation
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
Nitro-Dur dosage form
Transdermal patch
136
Nitro-Dur patient consultation
apply patch qam to chest or back
rotate application site daily to avoid irritation
remove patch after 12 hours
137
Lanoxin drug interactions (multiple)
Diuretics, amiodarone, erythromycin
138
Lanoxin adverse effects
anorexia, nausea, bradycardia, blurred vision, HA
139
Nitrates class contraindications
concomitant use with Viagra-class agents
140
nitrates class precautions
tolerance develops with daily/long-term use
| initiation during hypotension or volume-depletion
141
nitrates class drug interactions
```
ethanol (vasodilation)
arterial vasodilators (CCB -additive effects)
```
142
nitrates class adverse effects
HA, dizziness, flushing, nausea
143
nitrates class patient consultation
dosing schedule for "nitrate free" interval
HA (can use APAP)
orthostatic hypotension
avoid alcohol
144
Amiodarone pharmacology/PK
response may take weeks; mean half-life >50 days
145
Amiodarone drug interactions-multiple (high level surveillance)
Digoxin, WARFARIN (serious elevation in INR)
146
Amiodarone contraindications/precautions
Sinus node dysfunction
| pulmonary, hepatic toxicities
147
Amiodarone adverse effects
thyroid, ocular abnormalities, photosensitivity
148
Amiodarone patient consultation
lab and other monitoring very important; surveillance for toxicities
the pharmacist must confirm frequent warfarin monitoring will occur
149
Dronedarone contraindications
Class IV HF
| Class II and III HF if recently admitted for decompensated HF
150
Dronedarone adverse effects
N/V, diarrhea
151
dronedarone monitoring
LFTs
