Drugs and Indications Flashcards
metroNIDAZOLE (Flagyl)
- PUD (H. pylori)
- gynecologic infections
- CNS infections
- septicemia
- bone, joint infections
- endocarditis
- amebic dysentery
bismuth subsalycilate (Pepto-Bismol)
- non-severe diarrhea and GI Sx related to diarrheal illness
- PUD with H. pylori
- Tx/prevention of enterotoxigenic E. coli diarrhea
clarithromycin (Biaxin XL)
- PUD with H. pylori
- streptococcal pharyngitis
- sinusitis
- bronchitis
- pneumonia
- Tx (with ethambutol) and prevention of disseminated mycobacterium avium complex (MAC)
- pediatric infections
- otitis media
- sinusitis
- pharyngitis
- skin infections
- endocarditis prophylaxis
amoxicillin (Amoxil)
- skin, respiratory, and GU infections
- otitis media
- sinusitis
- PUD with H. pylori
- prophylaxis
- endocarditis
- postexposure: anthrax
- off-label: Lyme disease in children < 8 yr
tetracycline
- infections with unusual organisms
- mycoplasma
- chlamydia
- rickettsia
- borrelia burgdorferi
- in penicillin-allergic pts
- gonorrhea
- syphilis
- prevention of exacerbations of chronic bronchitis
- acne
tinidazole
- bacterial vaginosis
- trichomoniasis
- giardiasis
- amebiasis
- PUD with H. pylori
raNITIdine (Zantac)
- short-term: active duodenal ulcers and benign gastric ulcers
- maintentance: duodenal and gastric ulcers after healing
- management: gastric hypersecretory states (Zollinger-Ellison)
- Tx and maintenance: erosive esophagitis
- GERD
- OTC
- heartburn
- acid indigestion
- sour stomach
- IV, in critically ill: prevention, Tx of stress-induced upper GI bleed
omeprazole (PriLOSEC)
- GERD/maintenance of healing in erosive esophagitis
- duodenal ulcers (w/ or w/o anti-infectives for H. pylori)
- short-term: active benign gastric ulcer
- pathologic hypersecretory conditions (i.e. Zollinger-Ellison)
- ↓ risk of GI bleed in critically ill
- OTC: heartburn ≥ 2x/wk
sucralfate (Carafate)
- short-term management of and preventive management for duodenal ulcers
- off-label
- management of gastric ulcer or reflux
- prevention of gastric mucosal injury caused by high-dose aspirin or other NSAIDs in patients with RA or in high-stress situations (e.g., ICU)
- suspension: mucositis/stomatitis/rectal or oral ulcerations from various etiologies
aluminum hydroxide (Amphojel)
- ↓ phosphate levels in chronic renal failure
- adjunctive therapy for peptic, duodenal, and gastric ulcers
- hyperacidity
- indigestion
- reflux esophagitis
calcium carbonate (Tums, Maalox, Rolaids)
- Tx and prevention: hypocalcemia
- adjunct: prevention of postmenopausal osteoporosis
- acid indigestion or heartburn
- hyperphosphatemia in end-stage renal disease
magnesium hydroxide (Phillips, Dulcolax)
- Tx/prevention: hypomagnesemia
- high dose: bowel prep
- Milk of Magnesia: antacid
- low dose: prevent painful elimination (hemorrhoids, episiotomy)
- rapid evacuation for poinsoning or after anthelmintic therapy
miSOPROStol (Cyctotec)
- prevention: gastric mucosal injury from NSAIDs for geriatric or debilitated patients, or those ulcer Hx
- with mifepristone: termination of pregnancy
- off-label
- duodenal ulcers
- cervical ripening, labor induction
psyllium (Metamucil)
- constipation (temporary)
- ↓ diarrhea (diverticulosis and IBS)
- stool control for ileostomy/colostomy
docusate sodium (Colace)
- constipation
- softening of fecal impaction
bisacodyl (Dulcolax)
- constipation
- bowel prep
- bowel regimen in spinal cord injury
senna (Senokot)
- constipation w/ dry, hard stools and ↓ peristalsis
- opioid-induced constipation
lactulose
- chronic constipation
- adjunct: management of portal-systemic (hepatic) encephalopathy (PSE)
- ↓ blood ammonia in liver dz
diphenoxylate/atropine (Lomotil)
adjunctive therapy for diarrhea
loperamide (Imodium)
- adjunctive therapy of acute diarrhea
- chronic diarrhea associated with IBS
- ↓ volume of ileostomy drainage
metoclopramide (Reglan)
- prevention: chemotherapy-induced N&V
- acute and recurrent diabetic gastroparesis
- facilitation of small bowel intubation in radiographic procedures
- GERD
- Tx/prevention of postop N&V when NG suctioning undesirable
- off-label
- hiccups.
- adjunct: migraines
alosetron (Lotronex)
severe diarrhea-predominant (IBS) in women with chronic symptoms (≥ 6 mo), no other GI pathology, and no response to conventional therapy
lubiprostone (Amitiza)
- chronic idiopathic constipation
- IBS with constipation in women ≥ 18 yr
- opioid-induced constipation in those with chronic, non-cancer pain
sulfaSALAzine (Azulfidine)
- Tx
- mild-to-moderate ulcerative colitis
- rheumatoid arthritis unresponsive or intolerant to salicylates and/or NSAIDs
- adjunct: severe ulcerative colitis
albuterol (Ventolin, Pro-Air)
- prevention of exercise-induced asthma episode
- relief from bronchospasm
levalbuterol (Xopenex)
short-term relief of bronchospasm
salmeterol (Serevent)
- prevention of bronchospasm when asthma not controlled by SABA
- prevention of exercised-induced bronchospasm
- maintenance: COPD
formoterol (Perforomist)
maintenance, prevent bronchospasm in COPD
ipratropium (Atrovent)
- relieve bronchospasm r/t COPD, allergies, exercise
- off-label: asthma
theophylline
long-term control of chronic asthma, COPD
beclomethasone (Qvar)
- prevent inflammation
- ↓ mucus
- ↓ airway edema
- prophylactic
montelukast (Singulair)
- long-term Tx of asthma (adults, children)
- prevention of exercise-induced bronchospasm
codeine
- mild to moderate pain
- cough
- off-label: diarrhea
HYDROcodone
- ER: management of pain severe enough for 24-hr, long-term opioid Tx
- combos: management of moderate to severe pain.
- cough (usually in combo with decongestant)
dextromethorphan (Robitussin, Vicks DayQuil, Delsym)
- cough from minor viral upper respiratory tract infections or inhaled irritants
- most effective: chronic nonproductive cough
- common ingredient in OTC cough and cold meds
acetylcysteine (Mucomyst, Acetadote)
- PO, IV: antidote for overdose of acetaminophen
-
inhaled
- acute and chronic pulmonary disorders
- cystic fibrosis
guaiFENesin (Mucinex, Robitussin)
cough r/t viral upper respiratory tract infections
phenylephrine
- hypotension r/t:
- shock persisting after fluid replacement
- anesthesia
- anesthesia adjunct
- ↑ duration of spinal anesthesia
- localization regional anesthesia effect
ePHEDrine
hypotension during anesthesia
pseudoephedrine (Sudafed)
- nasal congestion r/t acute viral upper respiratory tract infection
- in combo with antihistamines: allergic conditions
- opens obstructed eustachian tubes in chronic otic inflammation or infection
diphenhydrAMINE (Benadryl, Unisom)
- allergic Sx caused by histamine release:
- anaphylaxis
- seasonal and perennial allergic rhinitis
- allergic dermatoses
- Parkinson’s disease and dystonic reactions from medications
- mild nighttime sedation
- prevention of motion sickness
- antitussive (syrup only)
promethazine (Phenergan)
- Tx: various allergic conditions and motion sickness
- preop sedation
- Tx and prevention: N&V
- adjunct: anesthesia and analgesia
dimenhyDRINATE (Dramamine)
nausea, vomiting, dizziness, and vertigo r/t motion sickness
loratadine (Claritin, Alavert)
- relief of Sx of seasonal allergies
- management
- chronic idiopathic urticaria
- hives
- off-label: chemo-related bone pain
cetirizine (Zyrtec)
- seasonal and perennial allergic rhinitis
- chronic urticaria
- off-label: chemo-related bone pain
fexofenadine (Allegra)
- Sx of seasonal allergic rhinitis
- chronic idiopathic urticaria
desloratadine (Clarinex)
- Sx of allergic rhinitis (seasonal and perennial)
- chronic idiopathic urticaria
azelastine (Astepro, Astelin)
- seasonal allergic rhinitis
- perennial allergic rhinitis (Astepro only)
- management of vasomotor rhinitis (Astelin only)
olopatadine (Patanase)
seasonal allergic rhinitis
mometasone (Nasonex)
- Tx and prevention of nasal Sx of seasonal and perennial allergic rhinitis
- Tx of nasal polyps
fluticasone (Flonase, Xhance)
- seasonal or perennial allergic rhinitis
- perennial nonallergic rhinitis (Rx only)
- nasal polyps (Xhance only)
triamcinolone (Nasocort, Kenalog)
- intranasal: seasonal and perennial allergic rhinitis
- chronic dz/disorder
- inflammatory
- allergic
- hematologic
- neoplastic
- autoimmune
- suitable for alternate-day dosing in chronic illness
- replacement therapy: adrenal insufficiency
budesonide (Rhinocort)
seasonal or perennial allergic rhinitis
aspirin (ASA)
- inflammatory disorders: RA, OA
- mild to moderate pain
- fever
- prophylaxis: transient ischemic attacks (TIA) and MI
- off-label: adjunct for Kawasaki disease
acetaminophen (Tylenol, Ofirmev)
- PO: mild pain, fever
- IV
- mild to moderate pain
- with opioid analgesic: moderate to severe pain
- fever
morphine
- severe pain
- 20 mg/mL oral solution for opioid-tolerant pts
- extended-release: severe pain requiring 24-hr, long-term opioid Tx (other Tx inadequate)
- pulmonary edema
- pain r/t MI
fentaNYL (Sublimaze)
- analgesic supplement to general or regional/local anesthesia
- induction/maintenance of anesthesia
- neuroleptanalgesia/neuroleptanesthesia
- preop and postop analgesia
- off-label: continuous IV infusion as part of PCA
meperidine (Demerol)
- moderate or severe pain (alone or with nonopioid agents)
- anesthesia adjunct
- analgesic during labor
- preop sedation
- off-label: rigors
methadone
- extended-release: moderate to severe chronic pain in opioid-tolerant patients requiring use of 24-hr, long-term opioid Tx (alternatives inadequate)
- detox and maintenance for opioid use disorder
- off-label: neonatal abstinence syndrome
oxyCODONE (Oxycontin)
- moderate to severe pain
- extended-release: severe pain requiring 24-hr, long-term opioid Tx (other options inadequate)
HYDROmorphone (Dilaudid)
- moderate to severe pain (alone or in combo with nonopioid analgesics)
- extended-release: moderate to severe chronic pain in opioid-tolerant patients requiring 24-hr, long-term opioid Tx (other options inadequate)
- antitussive (lower doses)
butorphanol (Stadol)
- moderate to severe pain
- analgesia during labor
- sedation before surgery
- supplement in balanced anesthesia
nalbuphine
- moderate to severe pain
- analgesia during labor
- sedation before surgery
- supplement to balanced anesthesia
buprenorphine (Buprenex)
- IM, IV: moderate to severe acute pain
- Buccal, Transdermal: severe pain requiring 24-hr, long-term opioid Tx (alternatives inadequate)
- Subdermal, SQ, SL: opioid dependence at various stages of detox
pentazocine (Talwin)
- moderate to severe pain
- analgesia during labor
- sedation prior to surgery
- supplementation in balanced anesthesia
naloxone (Narcan)
- reversal of CNS and respiratory depression in suspected opioid OD
- off-label
- opioid-induced pruritus (low-dose IV infusion)
- refractory circulatory shock
naltrexone
management of opioid or ETOH dependence
methylnaltrexone (Relistor)
- SC: opioid-induced constipation (OIC) in advanced illness or cancer pain
- SC, PO: OIC in chronic, non-cancer pain not requiring frequent dose escalation
amitriptyline
- depression
- off-label
- Anxiety
- insomnia
- Tx-resistant depression
- chronic pain syndromes (i.e., fibromyalgia, neuropathy, headache, low back pain).
carBAMazepine (Tegretol, Carbatrol)
- IV, PO: tonic-clonic, mixed, and complex-partial sz
- PO: trigeminal neuralgia pain
- Equetro: acute manic or mixed episodes associated with bipolar I disorder.
- off-label: other neurogenic pain
gabapentin (Neurontin, Horizant)
- partial sz (adjunct, immediate-release)
- postherpetic neuralgia
- restless legs syndrome (Horizant only)
- off-label
- neuropathic pain (including 2/2 DM)
- prevention of migraine
- bipolar disorder
- anxiety
methylphenidate (Ritalin)
- PO, transdermal: adjunct Tx for ADHD
- PO: Sx of narcolepsy
- off-label: adjunct for pain (↑ analgesia, ↓ sedation w/ opioids)
hydrOXYzine (Vistaril)
- anxiety
- preop sedation
- antiemetic
- antipruritic
dexamethasone (Decadron)
- systemically and locally in chronic diseases
- inflammatory
- allergic
- hematologic
- endocrine
- neoplastic
- dermatologic
- autoimmune
- cerebral edema
- Dx agent in adrenal disorders
- off-label
- (short-term) given to high-risk mothers to prevent respiratory distress syndrome in newborn
- chemo-induced N&V
- airway edema prior to extubation
- in neonates with bronchopulmonary dysplasia to facilitate ventilator weaning
predniSONE
- systemically and locally in chronic diseases
- inflammatory
- allergic
- hematologic
- neoplastic
- autoimmune
- suitable for alternate-day dosing in the management of chronic illness
- off-label
- adjunct for hypercalcemia
- adjunct for N&V from chemo
diazePAM (Valium, Diastat)
- adjunct for
- athetosis
- anxiety
- Stiffman Syndrome
- preop sedation
- conscious sedation (light anesthesia and anterograde amnesia)
- status epilepticus/uncontrolled sz
- skeletal muscle relaxant
- Sx of alcohol withdrawal
- off-label
- anxiety associated with acute MI
- insomnia
dantrolene (Dantrium)
- PO: Tx of spasticity r/t
- spinal cord injury
- stroke
- cerebral palsy
- multiple sclerosis
- malignant hyperthermia: prophylaxis, emergency Tx (IV), and prevention in high-risk pts
- off-label: neuroleptic malignant syndrome
baclofen
- PO: Tx of reversible spasticity due to MS or spinal cord lesions
- intrathecal: severe spasticity of cerebral or spinal origin (last resort, wait 1 yr after TBI)
- off-label: pain in trigeminal neuralgia
cyclobenzaprine (Flexeril, Amrix)
- acute painful musculoskeletal conditions r/t muscle spasm
- off-label: fibromyalgia
tiZANidine (Zanaflex)
↑ muscle tone r/t spasticity of MS or spinal cord injury
LIDOCAINE (Xylocaine, Lidoderm)
- IV: ventricular arrhythmia
- IM: self-injected or when IV unavailable (during pt transport)
- local: infiltration/mucosal/topical anesthetic
- transdermal: pain from post-herpetic neuralgia
succinylcholine
during surgical procedures to produce skeletal muscle paralysis after induction of anesthesia and provision of opioid analgesics
pancuronium
- skeletal muscle paralysis and facilitation of intubation after induction of anesthesia in surgical procedures
- facilitation of compliance during mechanical ventilation
- reversed by: neostigmine
heparin (Hep-Lock)
- evolving stroke
- pulmonary embolism
- massive DVT
- adjunct during open heart surgery or dialysis
- disseminated intravascular coagulation (DIC)
- prophylaxis
- DVT after hip/knee surgery
- large-bone Fx
- venous thromboembolism
- pulmonary emboli
- a-fib with embolization
- acute and chronic consumptive coagulopathies
- peripheral arterial thromboembolism
- very low doses (10–100 units) to maintain patency of IV catheters (heparin flush).
enoxaparin (Lovenox)
- prevention
- venous thromboembolism (VTE)
- DVT
- PE
- unstable angina, certain MIs (with aspirin)
- Tx
- DVT with or without PE (with warfarin)
- certain acute MIs (with thrombolytics or percutaneous coronary intervention)
warfarin (Coumadin, Jantoven)
- Tx: venous thrombosis
- prophylaxis and Tx
- embolization with a-fib and prosthetic heart valve
- recurrent TIAs, PE, DVT
- recurrent MI: ↓ risk of death, further embolization or MI
fondaparinux (Arixtra)
- prevention and Tx
- DVT
- PE
- off-labe: systemic anticoagulation for other Dx
dabigatran (Pradaxa)
- ↓ risk
- stroke/systemic embolization r/t nonvalvular a-fib
- recurrence of DVT or PE
- Tx: DVT or PE in pts treated with parenteral anticoagulant for 5–10 days
- prophylaxis: DVT or PE after hip replacement
rivaroxaban (Xarelto)
- prophylaxis: DVT that may → PE after knee or hip replacement
- ↓ risk of
- stroke/systemic embolism in a-fib
- recurrence of DVT and/or PE in pts with risk after 6 mo Tx
- (with aspirin) major cardiovascular events (cardiovascular death, MI, and stroke) in pts with chronic CAD or PAD
- Tx: DVT or PE
abciximab (ReoPro)
- (with heparin and aspirin) ↓ cardiac ischemic complications before or after percutaneous coronary intervention (PCI)
- off-label: (with heparin and and/or low-dose alteplase or reteplase) to enhance coronary perfusion in patients with acute coronary syndromes (ACS)
clopidogrel (Plavix)
- acute coronary syndrome: MI, angina
- established PAD, recent MI, or recent stroke
pentoxifylline (Pentoxil)
management of symptomatic peripheral vascular disease (intermittent claudication)
alteplase (Activase, t-PA)
- “clot buster”
- Tx
- acute MI
- acute ischemic stroke
- PE
- occluded central venous access devices
- off-label
- DVT
- acute peripheral arterial thrombosis
steptokinase (Streptase)
- “clot buster”
- acute MI
- PE
- DVT
- acute peripheral arterial thrombosis
- occluded arteriovenus cannulae
epoetin (Epogen, Procrit)
- anemia r/t or 2/2
- chronic kidney disease (CKD)
- zidovudine (AZT) therapy in HIV
- chemo in some cancer pts
- ↓ need for allogeneic RBC transfusions during elective, noncardiac, nonvascular surgery
filgrastim (Granix)
- prevention: febrile neutropenia and infection some cancer pts
- ↓ time for
- neutrophil recovery and duration of fever in some leukemia pts
- neutrophil recovery and sequelae of neutropenia in some cancer pts before bone marrow transplant
- prep for collection of hematopoietic progenitor cells
- severe chronic neutropenia
- ↑ survival in some radiation therapy pts
- off-label:
- neutropenia r/t HIV
- neonatal neutropenia
sargramostim (Leukine)
- acceleration of bone marrow recovery after:
- autologous bone marrow transplant in some cancers
- allogenic bone marrow transplantation from HLA-matched donors
- bone marrow transplant failure or engraftment delay
- after chemo for AML in patients ≥55 yr
- ↑ harvest of autologous peripheral blood progenitor cells (PBPCs)
oprelvekin (Neumega)
- prevention of severe thrombocytopenia
- ↓ need for platelet transfusion after myelosuppressive chemo some pts
furosemide (Lasix)
- edema due to HF, hepatic impairment, or renal dz
- HTN
hydroCHLOROthiazide (Microzide)
- mild to moderate HTN
- edema r/t
- HF
- renal dysfunction
- cirrhosis
- glucocorticoid therapy
- estrogen therapy
spironolactone (Aldactone)
- primary hyperaldosteronism
- edema r/t HF, cirrhosis and nephrotic syndrome
- essential HTN
- hypokalemia
- PCOS
- PMS
- acne in young females
mannitol (Osmitrol)
- IV: ↓ ICP and Tx of cerebral edema
- ↓ of elevated IOP (narrow-angle glaucoma)
- GU irrigant: during transurethral procedures
lispro insulin (Admelog, HumaLOG)
hyperglycemia in type 1 and type 2 DM
regular insulin (HumuLIN)
- control of hyperglycemia in DM
- U-500: pts requiring > 200 units/day
- off-label: hyperkalemia
NPH insulin
hyperglycemia in DM
insulin glargine
- trade name: Lantus
- class: antidiabetic, hormone, pancreatic
- route: SQ
- onset: long-acting
- DO NOT MIX
insulin glargine (Lantus)
hyperglycemia in patients with type 1 and type 2 DM
chlorproPAMIDE (Diabinese)
control of BG in type 2 DM when diet therapy fails (requires some pancreatic function)
glipiZIDE (Glucotrol)
adjunct to diet and exercise in type 2 DM (requires some pancreatic function)
pioglitazone (Actos)
type 2 DM (with diet and exercise)
acarbose (Precose)
type 2 DM in conjunction with dietary therapy
SITagliptin (Januvia)
adjunct to diet and exercise for type 2 DM
metFORMIN (Glucophage)
type 2 DM
pramlintide (Symlin)
with mealtime insulin in the management of DM not controlled by optimal insulin therapy
exenatide (Bydureon, Byetta)
- type 2 DM, as adjunct to diet and exercise
- not recommended as first-line therapy
glucagon (GlucaGen)
- acute management of severe hypoglycemia
- facilitation of radiographic exam of the GI tract
- off-label
- beta-blocker OD
- calcium channel blocker OD
levothyroxine (Levoxyl)
- hypothyroidism
- Tx or suppression of euthyroid goiters
- adjunct for thyrotropin-dependent thyroid cancer
propylthiouracil (PTU)
- for pts intolerant to methimazole
- Graves’ dz or toxic multinodular goiter, intolerant to methimazole, surgery or radioactive iodine therapy not appropriate
- adjunct in prep for thyroidectomy or radioactive iodine therapy
methIMAzole (Tapazole)
- palliative Tx of hyperthyroidism
- adjunct for hyperthyroidism in prep for thyroidectomy or radioactive iodine therapy
strong iodine solution (Lugol’s)
- adjunct in prep for thyroidectomy; ↓ thyroid size
- Tx: thyrotoxic crisis
- radiation protectant following radiation emergencies or administration of radioactive iodine
somatropin
- growth failure in children due to
- deficiency of growth hormone
- idiopathic short stature
- born small and fail to demonstrate catch-up growth by age 2-4 yr
- short stature r/t Turner’s syndrome
- SHOX deficiency
- growth hormone deficiency in adults as a result of
- pituitary dz
- hypothalamic dz
- surgery
- radiation
- trauma
- childhood onset
vasopressin (Vasostrict)
- central diabetes insipidus due to deficient antidiuretic hormone
- vasodilatory shock
- off-label: gastrointestinal hemorrhage
desmopressin (DDAVP)
- all forms: Tx of central diabetes insipidus caused by a deficiency of vasopressin
- IV, Intranasal: control bleeding in some hemophilia and von Willebrand’s dz
- Intranasal, SL: nocturia ≥ 2 times per night (Nocdurna only)
- PO, SL: primary nocturnal enuresis
hydrocortisone
- adrenocortical insufficiency
- systemically and locally in many disorders including
- inflammatory
- allergic
- hematologic
- neoplastic
- autoimmune
- septic shock
neostigmine (Bloxiverz)
- reversal of nondepolarizing neuromuscular blockers after surgery
- Tx of myasthenia gravis
physostigmine (Antilirium)
- reversal of some or all CNS effects due to OD of drugs capable of causing the anticholinergic syndrome
- belladonna or other plant alkaloids
- phenothiazines
- muscarinic antagonists
- tricyclic antidepressants
- antihistamines (i.e. promethazine)
edrophonium (Enlon)
- myasthenia gravis
- Dx
- assessment of adequacy of therapy
- differentiating from cholinergic crisis
- reversal of muscle paralysis from nondepolarizing neuromuscular blocking agents
donepezil (Aricept)
- mild to severe dementia/neurocognitive disorder r/t Alzheimer’s dz
- Parkinson’s dz
PHENobarbital
- tonic-clonic (grand mal), partial, and febrile sz in children
- preop sedative and in other situations requiring sedation
- hypnotic (short-term)
- off-label: prevention/Tx of hyperbilirubinemia in neonates
primidone (Mysoline)
- tonic-clonic, complex partial, and focal sz
- off-label: essential (familial) tremor
phenytoin (Dilantin)
- Tx/prevention: tonic-clonic (grand mal) and complex partial sz
- off-label: antiarrhythmic, particularly with digoxin toxicity, prolonged QT interval, and surgical repair of congenital heart dz in children
- neuropathic pain, including trigeminal neuralgia
valproic acid (Depakene)
- alone or as adjunct for
- simple and complex absence sz
- complex partial seizures
- adjunct: pts with multiple sz types
- bi-polar depression
- migraines
ethosuximide (Zarontin)
absence seizures (petit mal)
lamoTRIgine (Lamictal)
- adjunct
- partial sz in adults and children with epilepsy
- primary generalized tonic-clonic seizures in adults and children
- Lennox-Gastaut syndrome
- maintenance: bipolar disorder
levETIRAcetam (Keppra)
- adjunct
- partial onset seizures
- primary generalized tonic-clonic seizures
- myoclonic sz in patients with juvenile myoclonic epilepsy
- off-label: status epilepticus
topiramate (Topomax)
- sz including
- partial-onset
- primary generalized tonic-clonic
- due to Lennox-Gastaut syndrome
- prevention: migraine headache
- off-label
- adjunct for bipolar disorder
- infantile spasms
OXcarbazepine (Trileptal)
- alone or adjunct for partial sz
- off-label: trigeminal neuralgia
LORazepam (Ativan)
- PO: anxiety disorder
- IM, IV
- status epilepticus: IV, inpatient
- preanesthetic to produce sedation, ↓ preop anxiety and induce amnesia
timolol (Timoptic, Betimol)
- HTN alone or adjunct
- prevention
- MI
- migraine
- off-label
- ventricular arrhythmia
- essential tremor
- anxiety
brimonidine (Mirvaso)
- persistent (nontransient) facial erythema due to rosacea
- glaucoma
latanoprost (Xalatan, Xelpros)
- POAG
- glaucoma
- ocular htn
acetaZOLAMIDE (Diamox)
- ↓ IOP in glaucoma
- acute altitude sickness
- edema due to HF
- adjunct: refractory sz
- off-label:
- ↓ CSF production in hydrocephalus
- prevention: renal calculi composed of uric acid or cystine
carteolol (Ocupress)
POAG
metipranolol (OptiPranolol)
POAG
levobunolol (Betagan Liquifilm, AK-Beta)
POAG
betaxolol (Betoptic, Kerlone)
- HTN
- POAG/ocular HTN
levobetaxolol (Betaxon)
POAG/ocular htn
travoprost (Travatan)
POAG
bimatoprost (Lumigan)
POAG
bethanechol (Urecholine)
- PO
- postpartum and postop nonobstructive urinary retention
- urinary retention caused by neurogenic bladder
- investigational: GERD
oxybutynin (Ditropan, Gelnique, Oxytrol)
- urinary sx that may be associated with neurogenic bladder
- frequent urination
- urgency
- nocturia
- urge incontinence
- overactive bladder with urge incontinence, urgency, and frequency
darifenacin (Enablex)
overactive bladder with sx (urge incontinence, urgency, frequency)
tolterodine (Detrol)
Tx of overactive bladder ftn that results in urinary frequency, urgency, or urge incontinence
triazolam (Halcion)
short-term management of insomnia
ALPRAZolam (Xanax)
- generalized anxiety disorder (GAD)
- panic disorder
- anxiety r/t depression
- off-label
- Sx of PMS and PMDD
- insomnia, IBS, and other somatic sx r/t anxiety
- adjunct with acute mania, acute psychosis
midazolam (Versed)
- PO: preprocedural sedation and anxiolysis (pediatric)
- IM, IV
- preop sedation/anxiolysis/amnesia
- sedation/anxiolysis/amnesia during procedures (conscious sedation)
- continuous infusion: sedation of ventilated pt
- status epilepticus
- induction of anesthesia
- intranasal: acute treatment of intermittent, stereotypic episodes of frequent sz activity, distinct from an epileptic pt’s usual pattern
temazepam (Restoril)
short-term management of insomnia (< 4 wk)
zolpidem (Ambien)
insomnia with difficulties in sleep initiation
zaleplon (Sonata)
- short-term: insomnia in patients unable to get at least 4 hr of sleep
- especially useful in sleep initiation disorders
eszopiclone (Lunesta)
insomnia
captopril (Capoten)
- alone or adjunct: HTN
- management: HF
- following MI, ↓ risk of
- death
- HR-related hospitalization
- development of overt HF
- diabetic nephropathy in Type 1 DM and retinopathy
enalapril, enalaprilat (Epaned, Vasotec)
- alone or adjunct: HTN
- symptomatic HF
- ↓ progression of asymptomatic left ventricular dysfunction to overt HR
- off-label: proteinuria in steroid-resistant nephrotic syndrome patients
- enaliprat: hypertensive crisis
lisinopril (Zestril, Prinivil)
- alone or adjunct: HTN
- HF
- ↓ of risk of death or HF after MI
ramipril (Altace)
- alone or adjunct: HTN
- ↓ risk of MI, stroke, or death from CV causes in pts ≥ 55 yr with Hx of CAD, stroke, PVD, or DM (multiple factors)
- ↓ risk of death, HF-related hospitalizations, and HF progression in pts with s/sx of HF after MI
moexipril (Univasc)
alone or adjunct: HTN
benazepril (Lotensin)
alone or adjunct: HTN
losartan (Cozaar)
- alone or adjunct: HTN
- Tx: diabetic nephropathy in patients with type 2 DM
- prevention: stroke in pts with HTN and left ventricular hypertrophy
irbesartan (Avapro)
- alone or adjunct: HTN
- Tx: diabetic nephropathy in patients with type 2 DM and HTN
candesartan (Atacand)
- alone or adjunct: HTN
- Tx: HF in pts with left ventricular systolic dysfunction (can be used with an ACE inhibitor and beta blocker)
olmesartan (Benicar)
alone or adjunct: HTN
telmisartan (Micardis)
- alone or adjunct: HTN
- ↓ risk of MI, stroke, or CV death in patients ≥ 55 yr at high risk for CV events and unable to take ACE inhibitors
eplerenone (Inspra)
- alone or adjunct: HTN
- LV systolic dysfunction and evidence of HF post-MI
aliskerin (Tekturna)
alone or adjunct: HTN
NIFEdipine (Adalat, Procardia)
- management
- HTN (extended-release)
- angina pectoris
- vasospastic (Prinzmetal’s) angina
- off-label
- prevention: migraine
- management: HF or cardiomyopathy
verapamil (Calan, Verelan)
- HTN
- anginas
- supraventricular arrhythmias and rapid ventricular rates in atrial flutter or fibrillation
- off-label: prevention of migraine
dilTIAZem (Cardizem, Cartia, others)
- HTN
- anginas
- supraventricular tachyarrhythmias and rapid ventricular rates in atrial flutter or fibrillation
amLODIPine (Norvasc)
- alone or adjunct
- HTN
- angina pectoris
- vasospastic (Prinzmetal’s) angina
prazosin (Minipress)
- mild to moderate HTN
- off-label: urinary outflow obstruction in BPH
doxazosin (Cardura)
- immediate release, alone or adjunct: HTN
- symptomatic BPH
terazosin (Hytrin)
- alone or adjunct: mild to moderate hypertension
- s/sx of BPH
cloNIDine (Catapres, Duracion, Kapvay)
- PO, TD: mild to moderate HTN
- PO: ADHD (Kapvay only)
- Epidural: cancer pain
- off-label
- opioid withdrawal
- adjunct for neuropathic pain
guanFACINE (Intuniv, Tenex)
- HTN (immediate-release with thiazide diuretics)
- ADHD (extended-release)
methyldopa (Aldomet)
adjunct for moderate to severe HTN
metoprolol (Lopressor, Toprol)
- Hypertension.
- Angina pectoris.
- prevention: MI
- ↓ mortality with recent MI
- some HF (Toprol XL only)
- off-label
- ventricular arrhythmias/tachycardia
- migraine prophylaxis
- tremors
- aggressive behavior
- drug-induced akathisia (restlessness)
- anxiety
atenolol (Tenormin)
- HTN
- angina pectoris
- prevention of MI
esmolol (Brevibloc)
- sinus tachycardia and supraventricular arrhythmias
- hypertensive crisis
propranolol (Hemangeol, Inderal, InnoPran)
- Inderal, InnoPran
- HTN
- angina
- arrhythmia
- hypertrophic cardiomyopathy
- thyrotoxicosis
- essential tremors
- pheochromocytoma
- prevention and management: MI
- prevention of vascular headache
- Hemangeol: proliferating infantile hemangioma requiring systemic therapy
- off-label
- alcohol withdrawal
- aggressive behavior
- antipsychotic-associated akathisia (restlessness)
- situational anxiety
- esophageal varices
- investigational: PTSD
nadolol (Corgard)
- HTN
- angina pectoris
- off-label
- arrhythmia
- migraine prophylaxis
- tremors (essential, lithium-induced, parkinsonian)
- aggressive behavior
- antipsychotic-associated akathisia (restlessness)
- situational anxiety
- esophageal varices
- ↓ IOP
carvedilol (Coreg)
- HTN
- HF (ischemic or cardiomyopathic) with digoxin, diuretics, and ACE inhibitors
- left ventricular dysfunction after MI
labetalol
HTN
nitroprusside (Nipride, Nitropress)
- hypertensive crisis
- controlled hypotension during anesthesia
- cardiac pump failure or cardiogenic shock (alone or with dopamine)
NITROGLYCERIN (Nitrostat, GoNitro, etc.)
- acute and long-term prophylatic: angina pectoris
- HF
- IV: adjunct treatment of acute MI
- production of controlled hypotension during surgical procedures
- hypertensive crisis
niCARdipine (Cardene)
- HTN
- angina pectoris
- vasospastic (Prinzmetal’s) angina
- hypertensive crisis
clevidipine (Cleviprex)
- ↓ BP when oral therapy is not feasible/desirable
- hypertensive crisis
alvimopan (Entereg)
speed GI recovery following partial bowel resection surgery with primary anastomosis
fosinopril (Monopril)
- alone or adjunct: HTN
- management of HF
ibuprofen (Advil, Motrin)
- PO, IV
- mild to moderate pain
- fever
- PO
- inflammatory disorders including RA and OA
- dysmenorrhea
- IV
- moderate to severe pain with opioid analgesics
- closure of PDA in neonates (NeoProfen only)
naproxen (Aleve)
- mild to moderate pain
- dysmenorrhea
- fever
- inflammatory disorders
- RA
- OA
indomethacin (Indocin, Tivorbex)
- inflammatory disorders
- RA
- gouty arthritis
- OA
- ankylosing spondylitis
- mild to moderate acute pain
- IV: alternative to surgery in the management of patent ductus arteriosus (PDA) in premature neonates
DICLOFENAC
- PO: inflammatory disorders
- RA
- OA
- ankylosing spondylitis
- primary dysmenorrhea
- mild to moderate pain
- acute treatment of migraines (powder for oral solution)
- topical
- actinic keratoses (Solaraze)
- OA (Voltaren Gel, Pennsaid [for knees]).
- transdermal: acute pain from minor strains, sprains, and contusions
ketorolac (Toradol)
short-term management of pain (≤ 5 days total for all routes combined)
meloxicam (Mobic)
s/sx of OA and RA
celecoxib (Celebrex)
- Tx of s/sx of
- OA
- RA
- ankylosing spondylitis
- acute pain including primary dysmenorrhea
hydrOXYzine (Vistaril)
- anxiety
- preop sedation
- antiemetic
- antipruritic