EOR #7 pharm part 1 Flashcards
Common indications of mirtazapine
Major depressive d/o
MOA of mirtazapine
Increases release of serotonin and NE and potent antagonism of 5HT2 and 5HT3 serotonin receptors
Common adverse effects of mirtazapine
Drowsiness Dry mouth Increased appetite Constipation Wt gain Dizziness
Renal or hepatic dose adjustments for mirtazapine
May need an increased dose in renal impairment
BBW for mirtazapine
Increased suicidal thinking and behavior, especially in children and young adults
Clinically sig drug interactions with mirtazapine
MAO inhibitors
May increase risk of upper GI bleed with ASA or NSAIDs
Major counseling points of mirtazapine
Pay close attention and report sudden changes in mood, behavior, thought or feelings
May cause drowsiness
It takes 2 weeks before full effects are seen
Do not abruptly d/c this med
Monitoring parameters of mirtazapine
Improvement of s/sx of depression
Unusual changes in behavior
Suicidality
Common indications of Pen VK
Various infections
MOA of Pen VK
Inhibits cell wall mucopeptide biosynthesis
Common AEs of Pen VK
Black tongue
Diarrhea
Vomiting
Renal or hepatic dose adjustments for Pen VK
Consider dose adjustments with either renal or liver failure
Clinically sig drug interactions with Pen VK
May result in an increased INR when taken by a warfarin pt
Major counseling points of Pen VK
Take till empty
May affect the effectiveness of contraceptives
Monitoring parameters of Pen VK
Improvement in s/sx of infection, wbc
Common indications of Macrobid
UTI
MOA of Macrobid
inactivates bacterial ribosomal proteins and other large molecules resulting in inhibition of vital biochemical processes such as protein synthesis, aerobic energy metabolism, DNA synthesis, RNA synthesis, and cell wall synthesis
Common AEs of Macrobid
Nausea
HAs
Hemolytic anemia
Renal or dosage adjustments of Macrobid
Renal- CrCl <60: use is contraindicated
Clinically sig drug interactions with Macrobid
Hepatic and pulmonary toxicity can result from concurrent use with fluconazole
Major counseling points of Macrobid
May cause brown colored urine
Take this med with food
Monitoring parameters of Macrobid
Improvement in s/sx of infection, wbc
Common indications of donepezil
Alzheimers
MOA of donepezil
reversibly and noncompetitively inhibits centrally-active acetylcholinesterase, results in increased concentrations of acetylcholine available for synaptic transmission in the central nervous system
Common AEs of donepezil
Insomnia Diarrhea Nausea Vomiting Anorexia
Clinically sig drug interactions with donepezil
The metabolism of Aricept may be increased by phenytoin, carbamazepine, phenobarbital, rifampin, dexamethasone, or decreased by ketoconazole
Major counseling points of donepezil
23 mg tablet should not be broken or crushed
ODT should not be swallowed whole
Take in the evening before bed
Monitoring parameters of donepezil
Decreased or maintenances of s/sx of Alzheimers
Wt loss
Constipation
Common indications of famotidine
GERD
Ulcer
MOA of famotidine
Inhibits both the concentration and volume of gastric secretion
Common AEs of famotidine
Constipation
Diarrhea
Dizziness
HA
Renal or hepatic dose adjustments for famotidine
Renal CrCl 30-60: give 50% of recommended dose
CrCl <30: give 25% of recommended dose
Clinically sig drug interactions of famotidine
Can potentially lead to QT prolongation when taken along with escitalopram
Major counseling points of famotidine
Take this medication at bedtime
May take it with antacids if needed
Monitoring parameters of famotidine
Decrease in s/sx of GERD/peptic ulcers
Decreased GI sx
Common indications of ezetimibe
HLD
MOA of ezetimibe
Inhibits the uptake of cholesterol by the small intestine
Common AEs of ezetimibe
Diarrhea
Myalgia
Respiratory infection
Clinically significant drug interactions of ezetimibe
Use with gemfibrozil could lead to cholelithiasis
Major counseling points of ezetimibe
May cause muscle pain similar to that of statins
Take at least 2 hrs before or 4 hrs after a bile acid sequestrant
Monitoring parameters of ezetimibe
Cholesterol levels
Algias
Myalgias
Common indications of glipizide
Type 2 diabetes
MOA of glipizide
Stimulates insulin release from the pancreatic beta cells Reduces glucose output from the liver
Insulin sensitivity is increased at peripheral target sites
Common adverse effects of glipizide
Dizziness
Diarrhea
Mild hypoglycemia
Flatulence
Renal or hepatic adjustments of glipizide
Hepatic- initiate at 2.4 mg titrate from there
Clinically sig drug interactions of glipizide
Fluconazole: may increase the serum concentration of sulfonylureas
GLP-1 antagonist: may enhance the hypoglycemic effect of sulfonylureas- consider glipizide dose reduction
Major counseling points of glipizide
Take 30 mins before a meal ER tabs given with breakfast Maintain compliance while taking this medication Avoid excessive alcohol Could potentially cause hypoglycemia
Monitoring parameters of glipizide
Decrease in blood glucose/A1c
S/sx of hypoglycemia
Common indications of glyburide
Adjunct to diet in tx of type II DM
MOA of glyburide
Stimulates insulin synthesis and secretion from pancreatic beta cells
Common AEs of glyburide
Dicumerol, chloramphenicol, alcohol, MAOIs, phenylbutazones, salicylates, sulfinpyrazone, and sulfonamides may increase effects
Diazoxide, rifampin, and thiazide diuretics may decrease effects
Major counseling points of glyburide
Store in a cool dry place away from kids and sunlight
If you miss a dose, take it as soon as possible, if it is closer to the time for the next dose, skip the missed dose and return to normal dosing schedule – do not double doses
Take with breakfast or the first main meal
Compliance is necessary for optimal effect
Follow prescribed diet only
Avoid excess use of alcohol
Be aware of signs of hypoglycemia – sweating, tremor, blurred vision, weakness, hunger and confusion – and have oral glucose available to resolve this side effect.
Monitoring parameters of glyburide
Decrease in blood glucose/A1c
S/sx of hypoglycemia
Common indications of clobetasol
Psoriasis
MOA of clobetasol
Stimulates phospholipase A(2) inhibitory proteins and subsequently blocks the release of arachidonic acid, which is a common precursor to leukotrienes and prostaglandins
Common AEs of clobetasol
Eczema
Burning sensation
Pruritis
Major counseling points of clobetasol
Decrease in s/sx of psoriasis
Redness
Skin irritation
Decrease in inflammation
