EOR pharm part 1 Flashcards
Dosage forms of promethazine
Tab (12.5, 25, 50)
Syrup 6.25/5mL
Suppositories 12.5 mg, 25, 50
Injection 25 mg/mL, 50 mg/mL
Average daily dosages of promethazine
12.5-25 mg PO BID to q4-6 hrs PRN
Common indications for promethazine
Nausea
Motion sickness
Cough
MOA of promethazine
Competitively inhibits histamine at the H1 receptor sites, causing spasmolytic and decongestant effects
Common adverse effects of promethazine
Drowsiness Rash Nausea Vomiting Blurred vision Dry mouth Dizziness
BBW of promethazine
Do not use in patients younger than 2 years of age – potential for fatal respiratory depression; injection: tissue irritation and damage due to perivascular extravasation
Clinically significant drug interactions of promethazine
Anticholinergics may decrease effects
CNS depression with EtOH or other CNS depressants
Use with metrizamide may decrease seizure threshold
Barbiturate may decrease actions
Major counseling points of promethazine
May be taken with food or milk if GI upset occurs
May cause drowsiness
Avoid EtOH while taking this medication
Store in a cool dry place…
If dose is missed, skip it and return to nl dosing schedule- do not double doses
Drink plenty of water
Monitoring parameters of promethazine
Decrease in N/V
Decreased cough
Dosage forms of alendronate
Tablets: 5, 10, 35, 40, 70 mg Oral Solution: 70 mg/75 mL Fosamax plus Vitamin D tablets: 70/2800 IU, 70/5600 IU
Average daily dosages of alendronate
10-70 mg/day
Common indications for alendronate
Osteoporosis
Secondary osteoporosis due to glucocorticoids
Pagets disease
MOA of alendronate
Inhibits bone resorption via actions on osteoclasts or on osteoclast precursors; decreases the rate of bone resorption, leading to an indirect increase in bone mineral density
Common adverse effects of alendronate
Hypocalcemia Hypophosphatemia Abdominal pain Diarrhea Vomiting
Renal or hepatic dose adjustments of alendronate
Renal: CrCl <35: use not recommended
Clinically significant drug interactions of alendronate
Antacids must be given 30 minutes after taking alendronate or its serum concentration decreases
Major counseling point of alendronate
Administer first thing in the morning and ≥30 minutes before the first food, beverage (except plain water), or other medication(s) of the day.
Do not take with mineral water or with other beverages.
Patients should be instructed to stay upright (not to lie down) for at least 30 minutes and until after first food of the day (to reduce esophageal irritation),
Tablets and oral solution must be taken with a minimum of 6 ounces of plain water,
Do not crush or chew tablet.
Monitoring parameters of alendronate
Increase in bone density
Serum calcium/phosphorous
Dosage forms of allopurinol
Tablets (100mg, 300mg), Injectable solution (500mg in 30mL single dose vial)
Average daily dosages of allopurinol
200mg-300mg daily in mild gout,
400mg-600mg daily in moderate to severe gout, Max dose: 800mg/day
Common indications for allopurinol
Gout
Recurrent calcium oxalate stones
Prevention of uric acid nephropathy associated with chemo
MOA of allopurinol
Competitive inhibition of xanthine oxidase preventing the conversion of hypoxanthine to xanthine to uric acid
Common adverse effects of allopurinol
Rash
Drowsiness
Abdominal pain
N/V/D
Renal or hepatic dose adjustments for allopurinol
Renal- CrCl 10-20: 200 mg/day
CrCl 3-10: 100 mg/day
CrCl <3: 100 mg/48 hrs
Clinically significant drug interactions of allopurinol
Increases the effects and toxicity of mercaptopurine and azathioprine
Major counseling points of allopurinol
May take 1-2 wks to reach maximum effectiveness
Avoid EtOH while taking this med
Take with lots of fluids
Monitoring parameters of allopurinol
Decrease in serum acid levels
Frequency of gouty attacks
Pain relief
Dosage forms of enalapril
Injectable solution
PO tab
Powder for oral solution
Average daily doses of enalapril
Asymptomatic left ventricular dysfunction: Oral: 2.5 mg twice daily
Heart failure with reduced ejection fraction (HFrEF): 10 to 20 mg twice daily Hypertension: 10 to 40 mg daily
Common indications for enalapril
Asymptomatic left ventricular dysfunction
Heart failure
Hypertension
MOA of enalapril
ACEI
Common adverse effects of enalapril
Cough Hyperkalemia Angioedema Hypotension Dizziness Acute renal insufficiency
Renal or hepatic dosage adjustments for enalapril
Renal CrCl<30: initiate at 2.5 mg/day, max dose 40mg/day
BBW for enalapril
Fetal toxicity
Drug interactions with enalapril
Aliskiren
Major counseling points for enalapril
Avoid salt substitutes containing potassium.
Report any sign of angioedema
If planning on becoming pregnant immediately inform your physician
If a dose is missed, take it as soon as possible.
If it is closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.
Monitoring of enalapril
Decrease in BP
Decrease in S/sx of heart failure
Potassium
SCr
Dosage forms of ondansetron
Injectable solution Tablet Oral suspension Oral soluble film ODT OD
Average daily dosages of ondansetron
4 mg-8 mg PO up to TID
Common indications for ondansetron
Chemo/radiation
Postoperative N/V
MOA of ondansetron
Selective 5-HT3-receptor antagonist, blocking serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone
Common adverse effects of ondansetron
HA Lightheadedness Dizziness Drowsiness Tiredness Constipation
Clinically significant drug interactions of ondansetron
Apomorphine
Dronedarone
Major counseling points of ondansetron
Headache, lightheadedness, dizziness, drowsiness, tiredness, or constipation may occur.
If these effects persist or worsen, tell your doctor promptly.
To minimize dizziness and lightheadedness, get up slowly when rising from a sitting or lying position
Take 30 min prior to chemotherapy or anesthesia.
Monitoring parameters of ondansetron
Decrease in N/V
Dosage forms of valacyclovir
500 mg, 1000? mg
Average daily dosages of valacyclovir
1g 2-3 times a day
Common indications of valacyclovir
Herpes
HIV
MOA of valacyclovir
Valacyclovir is rapidly and nearly completely converted to acyclovir by intestinal and hepatic metabolism. Acyclovir is converted to acyclovir monophosphate by virus-specific thymidine kinase then further converted to acyclovir triphosphate by other cellular enzymes. Acyclovir triphosphate inhibits DNA synthesis and viral replication by competing with deoxyguanosine triphosphate for viral DNA polymerase and being incorporated into viral DNA.
Common adverse effects of acyclovir
Nausea
Vomiting
HA
Abd pain
Renal or hepatic dose adjustments for valacyclovir
Renal- dose adjustment based upon recommended dose
Clinically sig drug interactions with valacyclovir
Probenecid
Major counseling points for valacyclovir
Avoid sex while herpes sores are present. Use protective measures when engaging in sexual activities (male/ female condom)
Drug does not prevent transmission.
Drink plenty of fluids
Monitoring parameters of valacyclovir
Decrease in S/sx of herpes/HIV
